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TD BE SIGNED BY ALL APELIBAHTS i

I declare under penarry IDS-RUFF that the SIRIEITIEITIS and In This are IRIS 
I that by me DLIFDDSES IRS 

STUDENT SIGNATURE ETTE L.
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College Registration
Attestation and Signature Form

 

Thank you for choosing South Bay Regional Public Safety Training Consortium.
South Bay Regional is a Joint Powers Authority between the following California
Community Colleges:

-College ofSan Mateo -Hartnell College -Mt'rsiorl College
-Evergr2ert Valley College -La1re lelloe Communlly -Momerey Peninsula College
IFaorhilI College College ISzm Jose Clty College
IGaviIart College 'Ohlarre College

By completing the college registration form and signing this attestatiow
authorize South Bay Regional to enroll you in Marine at any of our Member
Colleges, Upon successful compEtton ofthe course. you will receive collEEe"
credit, which will be posted to an official college transcript.

You will be advised if the course is registered at a college different from the
attached registration form.

If you need an official transcript, make your request to the college of registration.
South Bay Regional can supply you with an "unofficial" transcript listing any/all
courses upon request and corresponding colleges of enrollment.

003:!



 

 

Attestation/Signature:
declare under penalty that the statements and information submitted by me in
connection with this application and for the determination of residency are true and
correct. All Materials submitted by me for the purpose ofadmission become the property
of South Bay Regional and its Member Colleges. I understand that falsification,
withholding pertinent data. or failure to report changes in residence may result in my
dismissal from the Collc e.

 
 
   

Strident Signatu 

iiscAL SkaK es College Applluttun Formx Application