Summer Sessions Certificate in Film & Media Industries and Professions - Completion Form
Students must take 3 approved courses in order to complete the certificate program. Courses may be taken all at once or over multiple summer sessions and years. Students should submit a completion form by week 3 of their third certificate course.
Name (Last, First): *
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UC Berkeley email:
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Permanent email: *
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Permanent mailing address (this is where we will send your certificate): *
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Permanent phone number: *
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What is your current student status? *
If you are a UC Berkeley student, please provide your SID:
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If you are a non-UC Berkeley student, what is your home institution?
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Major(s):
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Minor(s):
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Expected Graduation (semester and year):
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Please list the 3 BMIP courses you completed with instructor names and semester.
Ex. "Film 176: Pitch to Production, Kopell, Summer 2018"
Course 1: *
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Course 2: *
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Course 3: *
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Any additional information?
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Electronic signature (full name & date): *
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