APPENDIX L-2
CONTRA COSTA COMMUNITY COLLEGE DISTRICT
Credential Information
REQUEST TO GOVERNING BOARD TO ADD A MINOR FIELD
Type or Print
Name: ______________________________________________________________________________
Last First Initial
Social Security Number: __________________________ Minor: __________________________
Department: _________________________________________________________________________
College(s): __________________________________________________________________________
Type of credential: ____________________________________________________________________
Expiration date: ______________________________________________________________________
Majors (subject matter) listed on credential:
____________________________________________________________________________
____________________________________________________________________________
Limitations specified on credential:
____________________________________________________________________________
____________________________________________________________________________
Minors listed on credential (asterisk those added by Contra Costa Community College District Governing Board):
____________________________________________________________________________
____________________________________________________________________________
Restrictions to minor:
□ Requires annual Governing Board approval
□ Other: ______________________________________________________________
_______________________________________________________________
Courses used in Request to Governing Board to Add a Minor Field to Credential (see reverse side of page)
(24 units, of which at least 12 are upper division or graduate)
|
Institution |
Date Completed |
Course Number and Title |
Units LD. U.D.-Grad.
|
|
|
|||
_________________________ ________________
College FSA Review Team or Date
_________________________ ________________
President/Dean Date