Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO INFO 1 Principles of Business Computer Systems 3

CO INFO 8 Microcomputer Applications 3

CO INFO 15 Database Programming 3

CO INFO 16 Spreadsheet Applications 3

CO INFO 23 Programming Laboratory 1

CO INFO 64 Microcomputer Laboratory 1

Total Units 14

Application for AwardSKILLS CERTIFICATE IN BUSINESS SOFTWARE APPLICATIONSMajor Code: 070402

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO TECH 50 Basic Electronics for Computer Technicians 4

CO TECH 78 Introduction to Network + 4

ENG TEK 81 Fabrication Techniques 1

CO TECH 185 Directed Study – Computer Technology 1

CO TECH 285 Directed Study – Computer Technology 2

Total Units 12

Application for AwardSKILLS CERTIFICATE IN NETWORK TECHNOLOGYMajor Code: 079901

V: LAHC Cat 2019/20 - 03/2019

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO TECH 81 Introduction to Fiber Optics 1

Total Units 1

Application for AwardSKILLS CERTIFICATE IN FIBER OPTICSMajor Code: 070105

V: LAHC Cat 2019/20 - 03/2019

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO TECH 35 Intro to Linux + 3

CO TECH 76 A+ Certification Prep/Intro to PC Repair II 4

CO TECH 78 Intro to Network + 4

CO TECH 80 Intro to Server + 4

CO TECH 81 Intro to Fiber Optics 1

Total Units 16

Application for AwardSKILLS CERTIFICATE IN NETWORK ADMINISTRATIONMajor Code: 079900

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

Core (15 units)

CO TECH 35 Introduction to Linux + 3

CO TECH 50 Basic DC Electronics 4

CO TECH 52 Fundamental Computer Circuits & Lab 4

CO TECH 56 Computer Logic & Arithmetic 4

Electives (choose 13 units minimum)

CO TECH 49 Introduction to Dynamic Web Applications 3

CO TECH 74 A+ Certification Prep/Intro to PC Repair I 4

CO TECH 76 A+ Certification Prep/Intro to PC Repair II 4

CO TECH 78 Intro to Network + 4

CO TECH 80 Intro to Server + 4

CO TECH 114 Network Security Fundamentals 3

CO TECH 185 Directed Study 1

Additional Requirements (8 units)

ENGLISH 28 Intermediate Reading and Composition 3

or ENGLISH 100 Accelerated Prep: College Writing 3

or ENGLISH 101 Written Communications 3

CO TECH 60 Computer Mathematics I 5

or ENG TEK 49 Technical Mathematics II 5

Total Units 36

Application for AwardCERTIFICATE OF ACHIEVEMENTIN COMPUTER TECHNOLOGY Major Code: 093410

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO TECH 50 Basic Electronics for Computer Technicians 4

CO TECH 60 Computer Mathematics I 5

CO TECH 74 A+ Certification Prep/Intro to PC Repair I 4

CO TECH 76 A+ Certification Prep/Intro to PC Repair II 4

Total Units 17

Application for AwardSKILLS CERTIFICATE IN COMPUTER REPAIR TECHNOLOGYMajor Code: 070106

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

Core (12 units)

CO SCI 317 Micro Assembly Language Programming 3

CO SCI 340 Programming in C++ 3

CO SCI 344 Programming in Java 3

CO SCI 360 Introduction to Data Structures 3

Electives (choose 3 units minimum)

CO SCI 91 Beginning Basic Programming 3

CO SCI 92 Hypertext Markup Language 3

CO SCI 942 Discrete Structures 3

Total Units 15

Application for AwardSKILLS CERTIFICATE IN COMPUTER SCIENCEMajor Code: 070400

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO INFO 1 Principles of Business Computer Systems 3

CO INFO 7 Introduction to Multimedia 3

CO INFO 14 Introduction to Computer Communications 3

CO INFO 23 Programming Laboratory 1

CO INFO 64 Microcomputer Laboratory 1

CO SCI 344 Programming in Java 3

Total Units 14

Application for AwardSKILLS CERTIFICATE IN WEB DEVELOPMENTMajor Code: 070403

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO INFO 1 Principles of Business Computer Systems 3

CO INFO 015 Database Programming 3

CO INFO 021 Business Computer Programming 3

CO INFO 23 Programming Laboratory 1

CO INFO 64 Microcomputer Laboratory 1

CO SCI 092 HyperText Markup Language 3

or CO SCI 344 Programming in Java 3

Total Units 14

Application for AwardSKILLS CERTIFICATE IN PROGRAMMINGMajor Code: 070401

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

ART 633 Introduction to Computer Graphics 3

CO INFO 1 Principles of Business Computer Systems I 3

CO INFO 7 Introduction to Multimedia 3

CO INFO 8 Microcomputer Applications 3

CO INFO 9 Network System Manager 4

CO INFO 14 Introduction to Computer Communications 3

CO INFO 15 Database Programming 3

CO INFO 16 Spreadsheet Applications 3

CO INFO 21 Business Computer Programming 3

CO INFO 23 Programming Laboratory 1

CO INFO 24 Accounting on Microcomputers 2

CO INFO 64 Microcomputer Laboratory 1

CO SCI 92 HyperText Markup Language 3

CO TECH 35 Linux+ 3

CO TECH 80 Server+ 3

Total Units (Choose 30 units minimum) 30

Application for AwardCERTIFICATE OF ACHIEVEMENT INMICROCOMPUTER APPLICATIONS Major Code: 070210

V: LAHC Cat 2019/20 - 12/2018

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

BUS 001 Introduction to Business 3

BUS 032 Business Communications 3

CAOT 048 Customer Service 3

CO INFO 001 Principles of Business Computer Systems I 3

CO INFO 008 Microcomputer Applications 3

CO TECH 074 A+ Certification Preparation/Intro to Computer Repair I

4

CO TECH 076 A+ Certification Preparation/Intro to Computer Repair II

4

Total Units 23

Application for AwardCERTIFICATE OF ACHIEVEMENT: INFORMATION TECHNOLOGY TECHNICIAN (ITTP I) Major Code: 070200

V: LAHC Cat 2019/20 - 03/2019

Student Name:________________________________________

Student ID Number:____________________________________

Address:_____________________________________________

City:_________________________ State:_____ Zip:__________

Email:________________________________

Phone:_______________________________

By signing below I certify that all information is true and correct to the best of my knowledge.

Signature:________________________Date:_______________

Granted

Denied

PendingNotes: _______________________________________________________________________________

Reviewed by:_____________________

on date:_________________________

Student notified by email on date: _______________________________

Instructions to student: 1. Please complete this form.2. Attach copies of your transcripts which include classes required for this certificate.3. Return your completed application to Admissions & Records (SSA 218) 310-233-4020.4. A notice will be sent to you by email once your application is reviewed and processed.

FOR OFFICE USE ONLY Do not write in this box

Course Name Units Grade Semester Completed

Year Completed

CO INFO 001 Principles of Business Computer Systems 3

CO INFO 070 Cisco Networking Academy I 3

CO INFO 071 Cisco Networking Academy II 3

CO INFO 072 Cisco Networking Academy III 3

CO INFO 073 Cisco Networking Academy IV 3

Total Units 15

Application for AwardSKILLS CERTIFICATE IN CISCO NETWORK ACADEMYMajor Code: 070200

V: LAHC Cat 2019/20 - 12/2018