Updated 24/1
certapp.html      *** APPLICATION FOR CERTIFICATE ***

FILL OUT THIS APPLICATION AND MAIL (or HAND-DELIVER)  TO:
SOKO GAKUEN
1881 Pine Street
San Francisco, CA 94109
IF INCOMPLETE OR ILLEGIBLY WRITTEN, CERTIFICATES CAN'T BE ISSUED.
SOKO GAKUEN NEEDS 2 WEEKS TO PROCESS YOUR CERTIFICATE.
 

Your Name___________________________________ ♂♀   Date_________________
  . . . . .  . . . . . . . .  SURNAME (last name),  Given Name (first name)

Phone_____________________________    DOB(mmdd, eg 0911)___________________
Phone# used at Soko Gakuen,                                           If before W2010  SSN(last 4 digits)___________
 if different, write >                                      

Email _______________________________________________________________

 
BELOW LIST ALL OF THE COURSES YOU COMPLETED (MOST RECENT ONE FIRST).

Example:
BEGINNING 1,  SM . . . . . Fall 2023. . . . Y. Uda . . . . . . . . . . 98% . . . . . . . 10/11 (91%)
Course you completed, section . . Term, Year . . . Instructor's name . .  . Final exam score . . . Attendance rate
 

Course you completed, section, . Term, Year . . . Instructor's name . . .. Final exam score . . . Attendance rate
 

Course you completed, section, . Term, Year . . . Instructor's name .  . . Final exam score . . . Attendance rate
 

Course you completed, section, . Term, Year . . . Instructor's name . .. . Final exam score . . . Attendance rate
 

Course you completed, section, . Term, Year . . . Instructor's name .  . . Final exam score . . . Attendance rate
 

Course you completed, section, . Term, Year . . . Instructor's name .. . . Final exam score . . . Attendance rate
 

Course you completed, section, . Term, Year . . . Instructor's name . .. . Final exam score . . . Attendance rate

Note:
A CERTIFICATE OF COURSE COMPLETION shall be issued to the student who has
successfully completed a course or courses, (i.e., a final exam score of 80% OR HIGHER
and an attendance rate of 80% OR HIGHER). 

TO WHOM  DO YOU WANT THE CERTIFICATE SENT? (PLEASE WRITE LEGIBLY)

NAME :

ADDRESS :


PURPOSE OF THIS CERTIFICATE IS (STATE BRIEFLY HERE):
 
 

DO YOU WANT YOUR PROGRESS REPORT(S) ATTACHED TO THIS CERTIFICATE?
Yes?   No?

NOTES or COMMENTS:

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