PETITION FOR ASSOCIATE DEGREE
AND/OR
CERTIFICATE OF ACHIEVEMENT
11460 Warner Avenue
Fountain Valley, CA 92708-2597
FILING DATES:
SUMMER: June 13-July 15, 2016
FALL:
August 29-November 14, 2016
SPRING: February 1-April 4, 2016
PLEASE FILL OUT ALL INFORMATION COMPLETELY AND RETURN TO THE ADMISSIONS OFFICE BY FINAL DATE ABOVE
TO: 11460 WARNER AVE, FOUNTAIN VALLEY, CA. 92708 Attn. GRADUATION OR FAX TO 714-241-6288. EVALUATION
LETTER WILL BE EMAILED TO THE EMAIL ADDRESS YOU PROVIDE ON YOUR PETITION.
PRINT YOUR NAME AS YOU WISH IT TO APPEAR ON YOUR DEGREE AND/OR CERTIFICATE.
(Your application will be returned if not thoroughly filled out)
Name______________________________ ____________________
First
Address___________________________________
Number
___________________________________
Middle
Last
________________________________
Street
_______________
City/State
Zip Code
Student I.D. #__________________________________ Email: _________________________________________
WHICH DEGREE AND/OR CERTIFICATE ARE YOU REQUESTING AT THIS TIME
Associate in Arts
Option 1 _______ Option II (CSU) ______ Option III (UC) ______
Major or Area of Emphasis 1.__________________________2._____________________3.____________________
Please indicate if you’re transferring _____yes ____No
Name of transfer institution ____________________________________
Associate in Science
Major or Area of Emphasis 1.___________________________2._____________________3.____________________
Certificate of Achievement
Certificate Name 1._________________________2.________________________3._____________________
List year of academic guidelines you are following ________
ALL official transcripts from other educational institutions must be on file at the time you submit your application. It is the
responsibility of the student to have transcripts sent to Coastline Community College. List ALL educational institutions
you have attended that apply toward the Associate in Arts degree and/or Certificate of Achievement:
1.__________________________________________2._________________________________________3._________________________________
If you are currently attending any institution this semester (other than Coastline), list the institution, course(s), units and
projected completion dates. (List only if course(s) applies towards the degree and/or certificate).
_________________________________________________________________________________________________________________________
Before your Associate Degree and/or Certificate will be granted, you must provide official verification of your final
grade(s) from the institution(s) listed above. You are required to petition for the degree and/or certificate of achievement at
the beginning of the semester in which you will be completing your final requirements. If you are not currently enrolled
you will need to meet the current catalog degree requirements for the current academic year.
In the box below list the course(s) you are currently enrolled in (include “credit by exam” if applicable).
Course Number & Name
Units
Course Number & Name
Units
**YOUR APPLICATION WILL BE RETURNED IF RECEIVED PAST THE FILING PERIOD DEADLINE DATE.
Area of Emphasis
Majors
American Studies
Arts & Humanities
Communications
Physical Education & Health
Science & Math
Social & Behavioral Sciences
Art
Business Administration
Economics
English
French
Gerontology
Health & Fitness
History
Human Services
Liberal Studies (For Teaching)
Mathematics
Psychology
Sociology
Spanish
Associate in Science Degree
Students who wish to earn an A.S. Degree must meet the requirements for the certificates listed below along with the A.A. Degree requirements.
Accounting:
Bookkeeping
General Accounting
Taxation
Computer Networking:
Computer Networking: Cisco
Computer Networking: Microsoft
Computer Networking: Cyber Security
Building Codes Technology:
Code Professional
Combination Building Inspection
Combination Residential Inspection
Green Building Technology
Permit Technician
Business:
Business Administration
General Business
Human Resource Management
Marketing
Emergency Management/Homeland
Security:
Criminal Justice
Information Technology:
Informatics
Health Care Management:
Health Care Management
Office Support Specialist:
Administrative Manager
Administrative Professional Assistant
Financial Assistant
Financial Manager
General Office Manager
Certificates of Achievement
Certificates of Achievement
A.A. Degree Applicable as a Major
Gerontology
Management
Paralegal Studies
Process Technology
Retail Management
Small Business Ownership
Supervision & Management
Entrepreneurship & Small Business Management
Supply Chain Management
Not Applicable for A.A. Degree
Biological Technology
Biological Laboratory Technician
Digital Media Foundation
Digital Media Design
Print Design
Web Design
Web Technologies
Health Science
Process Technician Fundamentals
Real Estate Broker
Real Estate Studies
CSU G.E. Breadth
IGETC