DE ANZA COLLEGE GRADUATION APPLICATION FOR ASSOCIATE DEGREE
SID: __________________ Award Date: Fall Winter Spring Summer Year 20 ____
Member of Phi Theta Kappa Phone: ( )
PRINT NAME AS IT SHOULD APPEAR ON DIPLOMA Email:
Name: Other names used? ________________
!
Street:
City: State: Zip:
AA AS Major _________________________________________________________________
TO BE COMPLETED:
Requirements Pend
ing Quarter
Final
Grade
Student Agreement
I agree to notify the Evaluation Office at (408) 864-8651 or 8288 or 8375 if there are any changes to this application. I understand
it will be my responsibility to file another application if I do not fulfill the requirements pending.
Student Signature Date
Submit to: Evaluation/Admissions and Records Office Drop Box
Drop box located outside south entrance of Student and Community Services Building (near Bookstore)
Final Action – Evaluation Office Only
Honors: _______________________
Date:
_______________________________
Diploma mailed: ________________
Verified by:
________________________
List colleges attended, including Foothill:
College
ON FILE
Need
Offic
ial
Transcript
Yes No
Pre 83 De Anza*
Pre 83 Foothill*
*Check box if credit received prior to1983.
DIPLOMAS WILL BE MAILED 3 MONTHS
AFTER THE CLOSE OF THE QUARTER
IDENTIFIED ABOVE AS AWARD QUARTER.
REVISED: 5/1/13
Units Completed GPA
De Anza
Foothill
Transfer
TOTAL
Last Middle First
• Attach a DegreeWorks audit showing a
minimum of 95% compl
etion of program to
application by end of current term.
• Submit application with audit in the
Admissions and Records drop box located
outside south entrance of Student and
Community Services Building (near
Bookstore)
• Ap
proved petitions for course
substitutions/waivers must be on file in
A & R prior to submitting application.
