Co-Curricular Transcript (CCT) Activity Verification Form

Please complete the form below to have your event/activity considered for placement on the Co-Curricular Transcript.

Name of event/activity
Date of event/activity  (format: mm/dd/yyyy)
Is this an annual event? Yes No
Total hours of event/activity
Description or event/activity
What is the expected Learning Outcome of participation in the activity?
How will this Learning Outcome be measured? (ex. Survey, Focus group, Rubrics,etc.)
How will participation be documented?
Select one category that best indentifies the event/activity.
Sponsoring group/unit/department
Last name
First Name
Phone #

The Co-Curricular Transcript (CCT)|Contact

The City University of New York

Borough of Manhattan Community College
The City University of New York
199 Chambers Street, New York, NY 10007
212-220-8000 | Directory

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