Office of the Registrar

Application for Graduation

To be used by distance students only

First Name ________________________________  Middle Name ____________________________
Last Name _________________________________"S" ID Number____________________________
Current Street Address________________________________________________________________ City________________________ State_______________________ Zip________________________
Current Phone Number ___________________________________

Name of Advisor _________________________________________

PRINT NAME AS IT IS TO APPEAR ON DIPLOMA
First name:  
Middle name:  
Last name:  
MAILING ADDRESS FOR DIPLOMA
Street/PO Box:  
City:  
County:  
State:  
Zip:  
Degree 1st Major Code 2nd Major Code Minor Code
Bachelor of Arts      
Bachelor of Science      
B.S. in Business Adm.      
B.S. in Education      
Bach. of Gen. Studies      
Associate of Arts      
Associate of Science      

Anticipated Completion Date (date all requirements will be completed)

May _______(year)  Attending Ceremony? Yes or No / If yes - Height______ Weight _____
July _______(year)  July graduates will participate in May Commencement Ceremonies
Dec _______(year)  

Conditions:

I understand and agree to the following:

  1. That this application must be completed by October 25 or May graduates and April 25 for December graduates.
  2. If this application is not completed by the above dates, I accept full responsibility that I may not have adequate time to informed of and fulfill all requirements for the chosen graduation date.
  3. If seeking double degree or double major, this application must bear signature of each department concerned.

Signed _________________________________________  Date ________________________

 

 
MSSU Home • Welcome • Admissions • Athletics • Distance Learning • Alumni Association • Foundation • International • Calendar
copyright, non-discrimination, disability / accessibility • Disability Services Coordinator • text only Return to MSSU home page