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	INTENT TO COMPLETE THE HONORS PROGRAM By completing and submitting this form you declare your intention to meet all obligations required by the Honors Program and you verify that the e-mail address used will serve as your electronic signature to this commitment.
	Last Name: * First Name: * Middle Name / Initial: Chaffey Student ID Number: Mailing Address Street: City: State: Zip Code: Phone (include area code): E-mail Address: * Required
	CHECK IF APPLICABLE: I WILL CONTINUE TO ATTEND CHAFFEY. Projected completion date: I have not fulfilled all the requirements for the Honors Program graduation, but I do intend to transfer to a four-year school after the spring semester. I have or will have completed all Honors Program requirements by the end of the semester to graduate from the Honors Program. List the four-year institutions which you have applied to: I wish to participate in the upcoming Honors Graduation Dinner. I have contacted this professor/counselor and would like them to speak on my behalf at the dinner:
	PLEASE CHECK ALL OBLIGATIONS MET FOR HONORS PROGRAM GRADUATION: Maintained a GPA of 3.0 or higher Completed 54 hours of community service Completed the two- to three-page paper Turned in proof of service hours Completed 18 semester units in Honors Classes. List the classes, including courses in progress (e.g., English 1A): Additional comments or information relevant to this application: