APPLICATION FOR EVALUATION FOR A

REEDLEY COLLEGE CERTIFICATE

PLEASE READ ALL INSTRUCTIONS CAREFULLY! ANSWER ALL QUESTIONS THOROUGHLY. An evaluation will be mailed to you within four weeks. You are responsible for notifying the Evaluator of any of the following changes: Name Change (2) Address Change (3) Major Change (4) Errors in evaluation If eligible, your certificate will be mailed after final grades are processed and a final evaluation is completed. Only official certificates that are listed in the Reedley College Catalog will be awarded. Please refer to the most current Reedley College Catalog for the information required below.

PLEASE PRINT LEGIBLY

Student ID or Social Sec #	Telephone #

(Home) / (Cell)

PRINT YOUR NAME AS YOU WANT IT TO APPEAR ON YOUR CERTIFICATE

____________________________________________________________________________________

(First)	(Middle)	(Last)

The address where you wish your certificate mailed to:

____________________________________________________________________________________

(Street Address)	(City)	(State)	(Zip)

Print the name of the certificate as it exactly appears in the Reedley College Catalog

___________________________________________________________________________________

When do you plan to complete the certificate requirements: Month _____________ Year ___________

Do you plan to participate in the CTE Certificate Ceremony: Yes_____________ No ______________

Please return this application to the Admissions and Records Office

DATE______________________ STUDENT SIGNATURE________________________________________