Intent to complete the Honors Program

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First Name:*

Middle Name / Initial:

Last Name:*

Chaffey Student ID Number:

Mailing Address

Street:

City:

State:

Zip Code:

Phone (include area code):

E-mail Address:*

CHECK IF APPLICABLE:

I WILL CONTINUE TO ATTEND CHAFFEY.

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 current academic year to graduate from the Honors Program.

I have applied to four-year institutions

I wish to participate in the upcoming Honors Graduation Dinner.

If you will continue to attend Chaffey. Projected completion date:

List the four-year institutions to which you have applied:

If you wish to participate in the upcoming Honors Graduation Dinner. MANDATORY: I have contacted this professor/counselor to write on my behalf for the Honors Program Graduates booklet: Name of Professor/Counselor

PLEASE CHECK ALL OBLIGATIONS MET FOR HONORS PROGRAM GRADUATION:

Maintained a GPA of 3.2 or higher

Completed 10 hours of community service

Completed 15 units.

If you completed 10 hours of community service, please select:

I understand that in order to be eligible for scholarships for graduating Honors students, I must complete the three-page paper on the following topic, due via email to dorothy.nevarez@chaffey.edu by February 7, 2020. PROMPT: How the Honors Program and My Community Service Influenced My Life While At Chaffey College

Turned in proof of service hours

If you completed 15 units. List the classes, including courses in progress (e.g., English 1A):

Additional comments or information relevant to this application:

Intent to complete the Honors Program

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