Application for Degree

Application for Degree
Name:*

First NameLast Name
Student ID number:*
Southwestern E-mail:*
example@example.com
Personal E-mail:*
Phone number:*

Area CodePhone Number
Diploma Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Hometown*
For publication in Commencement Program
Do you plan to attend Commencement*
Name for Diploma and Commencement Program
Please include the name you wish to appear on the diploma and commencement program. Use upper and lower case and any special accents.
Prefix:
First Name:*
Middle Name or Initial:
Last Name: *
Suffix:
For more information visit the Diploma Name Policy Website
If your name is hard to pronounce, please provide the Phonetic Spelling:
First: Middle: Last:
Degree or Certificate Information
Degree or Certificate Type *
Major/Certificate #1
Other
Type in major/certificate if not listed above
Major/Certificate #2
Other
Type in major/certificate if not listed above
Minor #1
Other:
Type in minor if not listed above
Minor #2
Other:
Type in minor if not listed above or 3rd minor
Term of Completion
Type a question*

Fall term (degree conferred on December 30th)- requirements must be completed by December 15th or the last day of classes & application for degree received by Registrar by November 1stSpring term (degree conferred on day of Commencement) - requirements must be completed by last day of classes & application for degree received by Registrar by April 1stLate Spring term (degree conferred on May 30th) - requirements must be completed by May 15th or last day of classes & application for degree received by Registrar by April 1stSummer term (degree conferred on August 30th) - requirements must be completed by August 15th or last day of classes & application for degree received by Registrar by July 1st. Summer applicants wanting name in Commencement Program must submit application by April 1st.
Please list any college work not yet submitted on an official transcript to Southwestern College (previously taken, in progress, or planned)
Include name of courses with name of school or testing organization
Certification by applicant*

I have reviewed my academic progress with my advisor and will fulfill all course, GPA, and hour requirements for the above degree and major(s) as outlined in the college catalog.I acknowledge that participation in the commencement ceremony does not guarantee that I have met all degree requirements.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Name for Diploma and Commencement Program

Degree or Certificate Information

Term of Completion