Rev 10/15
APPLICATION FOR CERTIFICATE OF COMPLETION
(Submit a separate application for each certificate)
NAME SID#
PRINT as you wish it to appear on your certificate
EMAIL ADDRESS:
ADDRESS you want certificate mailed to:
City State Zip
YEAR & QUARTER in which you expect to complete the graduation requirements:
Year Fall (Dec.) Winter (March) Spring (June) Summer (Aug.)
This certificate is from the GHC catalog year
Type of certificate for which you are applying
Accounting/Bookkeeping
Advanced Diesel Technology
Automotive Technology
Business Management
Business Technology
Carpentry Technology
Chemical Dependency (2014)
Commercial Food Preparation (2014)
Commercial Transportation & Maintenance
Criminal Justice
Diesel Technology Fundamentals
Early Childhood Ed State Certificate
US Veteran Yes No
Member of Phi Theta Kappa Yes No
Student Signature Date
Forestry Technician
Human Services
Medical Office Administrative Support
Power Technology
Practical Nursing
Related Welding Technology
Small Business/Entrepreneurship
Welding Technology
Preliminary OK Date
FOR OFFICE USE ONLY
Approved: YES NO
Date: By:
GPA:
Comments: