Appendix L-2
For a usable version of this form, please download the PDF of the UF Contract from our website, and print this form.
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.
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_________________________ ________________
College FSA Review Team or Date
_________________________ ________________
President/Dean Date