Evaluation Worksheet for Certificate		Health Careers Academy
SID:	________________________________	Skills Certificate - 5101
		Effective: Fall 2018
		Health Sciences
Name:	________________________________	(707) 524-4630

REQUIREMENTS: Complete 4.5 units Health Careers Academy - complete 4.5 units Course Description Units Completed In Progress Comments HLC 121  Health Careers Academy I 1.5       HLC 121L  Health Careers Academy Lab I 0.8       HLC 122  Health Careers Academy II 1.5       HLC 122L  Health Careers Academy Lab II 0.8

	Evaluation worksheet completed upon receipt of Transfer Credit Evaluation form. Includes credit from other institutions only received to date.
	Evaluation worksheet completed for ________________________________. Includes all SRJC and transfer credit received to date.

Units completed:    __________ Units in progress:    __________ Total:    __________

Requirements Completed     Pending (work in progress)     Requirements Not Completed

Comments

Date: ________________________   By: ____________________________________________