DE ANZA COLLEGE GRADUATION APPLICATION FOR ASSOCIATE DEGREE
Year 20 ____
Phone:
Email:
PRINT NAME EXACTLY AS IT SHOULD APPEAR ON DIPLOMA
Name:
First Middle
Last
Street:
City:
State: Zip:
AA AS
Major ____________________________________________________________
TO BE COMPLETED:
List colleges attended, including Foothill:
Student Signature Date
REVISED: 03/15/17
Final Action – Evaluation Office Only
Honors: _______________________
Date:
Diploma mailed: ________________
Verified by:
Units Completed GPA
De Anza
Foothill
Transfer
TOTAL
Requirements Pending Quarter
Final
Grade
College
ON FILE
Need
Official
Transcript
Yes No
Pre 83 De Anza
Pre 83 Foothill
•
Attach a Degree Works audit sho
wing a
minimum of 95% completion by the end of the
current term, for the Degree you are
applying for.
•
Submit application with audit to the Admissions
and Records drop-box located outside the south
entrance of the Registration & Student Services
Building. Please make sure to retain a copy for your
records.
•
Attach photocopies of the front &back of current
CPR and 1
st
Aid certifications if required for
Child Development, Health Technologies or
Massage Therapy programs.
•
Approved petitions for course substitutions
must be on file in A&R prior to submitting
your application.
Instructions & Information
Phi Theta Kappa
CWID: __________________
Winter Spring
Summer
Student Agreement
I agree to notify the Evaluation Office at (408) 864-5300 or diploma@fhda.edu if there are any changes to this application. I understand I must
complete courses in progress to meet the requirements for the degree. It will be my responsibility to file another application, if I do not fulfill
the requirements pending. I understand if I am eligible for any other degrees, they will be awarded automatically along with the degree indicated.
If I would not like any further degrees I am eligible for awarded, I will contact the number above.
You will receive notifcation about your printed
diploma approximately 3 months after the end of the
quarter.
Applications must be submitted by
the first day of the final month of the
quarter in which you apply. Please
visit www.deanza.edu for exact
dates.
Award Quarter :
Fall
click to sign
signature
click to edit
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