Apply for a Pathway Certificate

INSTRUCTIONS: This application applies only to students who completed Pathway prior to January 2015.

Students who finished Pathway with a minimum cumulative 3.0 GPA may apply to receive a Pathway Certificate by completing the following form:

Identification Information
First Name:
Middle Name:
Last Name:
I-Number:
Telephone Number:
E-mail:
Semester of Completion

When did you complete Pathway?

Winter Semester (April) Spring Semester (July) Fall Semester (December) Year:
Certificate Name

How should your name be printed on your certificate?

First Name:
Middle Name:
Last Name:
Mailing Address

Where should we send your certificate?

Address Line 1:
Address Line 2:
City:
State/Province/Country:
Zip/Postal Code:
Country: