Certificate Application

General Information

Student ID*field type single line
XXXXXXX
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Email Address*field type single line
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Last Name*field type single line
Input blocked. Maximum character limit of 40 characters reached.
First Name*field type single line
Input blocked. Maximum character limit of 40 characters reached.
Middle Namefield type single line
Input blocked. Maximum character limit of 40 characters reached.
Date of Birth*field type date
LastNameAlphafield type single line
Input blocked. Maximum character limit of 4000 characters reached.
This field contains a calculation error.
References: Last Name

Requirements

1. PLEASE NOTE: You must submit one application per degree.

2. Students must have completed a minimum of 12 units in Residence at San Bernardino Valley College.
Have you met with a counselor?field type radio button
Have you met with a counselor?YesNo
The certificate application does not require a counselor meeting/grad check. We suggest and encourage certificate applicants to meet with a counselor, but it is not required of them
Counselor Namefield type single line
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Graduation Checkfield type file upload
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Please upload Graduation Check from Starfish

Student Information

Semester of Application*field type drop-down
All requirements must be completed in this semester
Please indicate your Graduation Year*field type number
Year First attended SBVC*field type number
List all previous names used at SBVC, IF ANY.
×
- First Namefield type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Last Namefield type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Middle Namefield type single line
  Input blocked. Maximum character limit of 4000 characters reached.
Add
Your degree will be printed with the name exactly as recorded on your student transcript. Your Diploma and/or Certificates will be mailed to the mailing address on record with the Admissions & Records Office. To update your address, send a Change of Information request to sbvcadmissions@valleycollege.edu.

Major Information

Catalog Year*field type drop-down
Other Catalog Year*field type single line
XXXX-XXXX
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Typefield type single line
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Certificate*field type drop-down
Certificate Program*field type drop-down
Other Certificate Program*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Program Codefield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Are you currently enrolled in another institution?*field type radio button
Are you currently enrolled in another institution?YesNo
Other Current Institution*field type multi line
Current Class Schedule (Only if the course is required for this degree)*field type file upload
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Official Transcripts from all colleges attended must be on file with Admissions & Records. Please note that equivalencies may not be possible without course descriptions for classes taken prior to 1995. Contact your prior institutions attended to obtain course descriptions with approved General Education areas and attach them to the Application to Graduate.
List ALL colleges or universities you have attended other than SBVC. Indicate if you have other credit to be included. Note: ALL official transcripts (course description if applicable) must be on file with the Admissions & Records Office - Send official transcripts to: Admissions@valleycollege.edu.
Institutions*field type radio button
InstitutionsNEVER attended another institution.All institutions attended listed below.
Colleges Attended
×
- Institution*field type multi line
Add College
Select all that applyfield type checkbox
Select all that applyModification of MajorCertificates of professional trainingMilitary CreditAdvance Placement/International Baccalaureate/CLEP/Official Transcript
Modification of Major Document*field type file upload
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Certification of professional training document*field type file upload
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DD214 Document*field type file upload
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Advanced Placement/International Baccalaureate/CLEP Document/Official Transcript*field type file upload
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Student Permissions

To be completed by all students

I give permission for my name, major and graduation honors to be printed in the Commencement Program.*field type radio button
I give permission for my name, major and graduation honors to be printed in the Commencement Program.YesNo
I give permissions for my name, major and graduation honors to be printed in Media.*field type radio button
I give permissions for my name, major and graduation honors to be printed in Media.YesNo
I give permission to release my email & Mailing address required by the Commencement Photographer.*field type radio button
I give permission to release my email & Mailing address required by the Commencement Photographer.YesNo

Student Declaration

I hereby certify, under penalty of perjury, that the information provided in this form is complete and accurate and that I have read and understand the information in both pages of this form. I understand it is my responsibility to monitor my college email account for results of this request.
Full Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Signature*field type signature
This constitutes as e-signature
Submission Date*field type date
Date will be captured on form submission
Processing time may take up to 8 weeks during peak periods.

Certificate Application

General Information

Requirements

Student Information

List all previous names used at SBVC, IF ANY.

Major Information

Student Permissions

To be completed by all students

Student Declaration