The Honors Transfer Program - San Bruno

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Application Form
Skyline College
The Honors Transfer Program
Date Submitted:
For Semester:
Last Name:
First Name:
FALL 
SPRING 
MI:
Student ID or Social Security Number:
Home Address:
City:
Telephone:
Zip:
E-mail:
High School attended:
Graduated (m/year):
HS GPA:
Eligibility and Application Checklist:
 I am eligible for both ENGL 100 (Composition) and MATH 120 (Intermediate Algebra).
I also have at least one of the following:
 A high school GPA of at least 3.5 --- please attach a copy of your HS transcript(s)
OR
 A cumulative college GPA of at least 3.25 in at least 9 units of degree applicable courses.


 I do not meet the two eligibility requirements above, but I wish to be admitted into the Program
on a provisional basis.
I also understand that I will be interviewed by the Honors Coordinator or the Honors Counselor.


If you are accepted into the program, would you give your permission to share educational records
with our honors transfer partners?
 yes
 no
How did you hear about the Honors Transfer Program? __________________________________________
Referred by: ______________________________________________________________________________
Please indicate your major or primary field of academic interest: ___________________________________________
When do you intend to graduate from Skyline?________________________________
Universities you would like to attend:
(1) __________________ (2) __________________ (3) ______________
Are you a member of Phi Theta Kappa?
yes
Your Signature:
no
Today’s Date:
Please mail completed form to: Katharine Harer, HTP Coordinator, Language Arts Division,
Skyline College - 3300 College Drive, San Bruno, CA 94066 or Honors Office: Building 4, Room 4242
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