VICTOR VALLEY COLLEGE, 18422 Bear Valley Road, Victorville, CA 92395-5850  (760) 245-4271
OCCUPATIONAL EDUCATION – CERTIFICATE VERIFICATION SHEET
Date
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OFFICE USE ONLY:
CODE NO. _______________________________
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STUDENT ID NUMBER
CERT. ISSUED __________ DATE ____________
College courses taken elsewhere that apply to this certificate.
List colleges: __________________________________
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Applicable Catalog
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CERTIFICATE YOU WISH TO APPLY FOR : _____________________________________________________________________
PRINT YOUR NAME IN CAPITALS as it is to appear on the certificate: _________________________________________________
Mailing address where you wish the certificate to be sent: ____________________________________________________________
Street Address/P.O. Box
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Area Code Current Phone Number
____________________________________________________________________
City
State
Zip Code
DO NOT WRITE BELOW THIS LINE
COURSES COMPLETED OR IN PROGRESS:
COURSE
EQUIVALENT
UNITS
GRADE
TERM/YR
COMPLETED ELSEWHERE
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Eval./Update
Letter Sent
DEFICIENCIES ________________________________________________________ _________________ _________________
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VERIFICATION OF COMPLETION
APPROVAL:
Evaluator ____________________________________ Date _______________ Occupational Education ______________________
10/19/10
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