White: records; pink: student
Do you plan to participate in the
Graduation Ceremony? Yes No
If yes, you may order cap & gown online.
Cords may be purchased in the Crowder
Bookstore.
APPLICATION FOR GRADUATION
Today’s Date: _________________________ Student ID#: ___________________________
Print your name as you wish it to appear on your diploma. Degree___________________
_________________ _______________ ______________________ Major____________________
First Middle Last
Month/Year of Graduation: ___________/___________
Phone #: _____________________________ Cell #: ______________________
Personal email address:_____________________________________________
Mailing Address__________________________________________ City: __________________ State: _____ Zip: ______
Does your diploma need to be mailed to a different address? yes no
Mailing Address__________________________________________ City: __________________ State: _____ Zip: ______
So that we can keep in touch with you to keep you updated, please list three people that will always know where you are.
1. ________________________________ ___________________________________ ______________
Name/Relationship Address Phone #
2. ________________________________ ___________________________________ ______________
Name/Relationship Address Phone #
3. ________________________________ __________________________________ ______________
Name/Relationship Address Phone #
You must take the required graduation exit exam and clear your account in the Cashier’s Office or a diploma will NOT be issued. Participating in the
graduation ceremony does not guarantee degree completion. All courses must be completed with satisfactory grades and must have a cumulative
grade point average of 2.0 or above to meet the graduation requirement. If you have transferred courses from other colleges, you must complete
15 of your last 30 hours at Crowder College.
Office Use Only
Date Requirement Met
Graduation Exit Exam Date Taken
Account Balance
PTK
Grade Point Average
Honors
MOGEA Passed (Education major)
Approved by VP Student Affairs
Diploma Mailed
DEADLINE FOR APPLYING
May Graduates: October 1
December Graduates: March 1
Summer Graduates: March 1