CCCC Continuing Education Creative Writing Program
Verification of Successful Completion of Creative Writing Class
For Students who intend to earn a certificate in Creative Writing:
At the completion of each creative writing class, fill out this form completely (except for the
instructor’s signature) and give it to your instructor to sign at the last meeting.
Important: You are responsible for turning the form into the Continuing Education Department
after it has been signed by the instructor.
Student Name
Name of Class
Class number
Name of Instructor
Class start date (mo-day-year)
Class end date (mo-day-year)
Class meeting time
___________ to ______________
Instructor: Please sign below to verify that the above student attended at least 70% of the class
hours and successfully completed all requirements for the class.
Date:
_______________
Signed by ____________________________________
Student: Return form to CCCC, Continuing Education, 764 West St., Pittsboro, NC 27312,
Attention Maggie Zwilling. For more information email mzwil272@cccc.edu or call
919.545.8048