Fillable App-deg LOUISIANA STATE UNIVERSITY AT EUNICE

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App-deg LOUISIANA STATE UNIVERSITY AT EUNICE

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LOUISIANA STATE UNVIVERSITY EUNICE
APPLICATION FOR DEGREE/CERTIFICATE
Business Office
Science Building, Room 111
LSU Eunice P.O. Box 1129
Eunice, LA 70535
busaffair@lsue.edu
NAME
ADDRESS
SEMESTER/YEAR GRADUATING
LSUE Student ID #
CITY STATE ZIP
PHONE NUMBER
Home Work/Cell
PRINT NAME EXACTLY AS IT IS TO APPEAR ON THE DIPLOMA, INCLUDING ALL ACCENT MARKS, PUNCTUATION, AND SPACING:
FIRST
MIDDLE (If desired)
LAST
SUFFIX (Jr., Sr., III, Etc.)
ASSOCIATE DEGREE TO BE AWARDED (select one):
CERTIFICATE OF TECHNICAL STUDIES TO BE AWARDED (select one):
[ ] Certificate of Technical Studies in Accounting Technology:
Account Clerk
Certificate of Technical Studies
in Administrative Technology
Certificate of Technical Studies in Chemical Technician
Certificate of Technical Studies in Human Resources Management
Certificate of Technical Studies in Medical Billing
and Coding
Certificate of Technical Studies in Fire Service Technology
SUBMIT THIS APPLICATION TO THE OFFICE OF BUSINESS AFFAIRS TO PAY YOUR DIPLOMA/CERTIFICATE FEE. If you notify the Registrar’s Office
of a change in your graduation date prior to the ordering of the diploma/certificate, then your diploma fee will be refunded or rolled over to the next semester. No refund,
however, can be authorized if you notify the Registrar’s Office of a change in your graduation date after the diploma/certificate has been ordered. If your graduation
plans change, then you will need to re- file a new Application for Degree/Certificate indicating your new graduation date and pay the applicable fee.
DIPLOMA FEES: ASSOCIATE DEGREE $45.00; CERTIFICATES $20.00
DATE
SIGNATURE
SOCAIL SECURITY NUMBER
STUDENT NUMBER
**************************************************************************************************************************************************************************
GRADUATION REQUIREMENTS-COMMENCEMENT INFORMATION
Pay all financial obligations owed to the University. If you have received any type of guaranteed student loan through the University, you must attend an exit interview prior to graduation.
You must participate in the graduation ceremony. If you are unable to attend, you must request permission to be awarded your degree in absentia. Present your request to
the Dean of Enrollment Management. In absentia diplomas may be picked up in the Office of Enrollment Management after the graduation exercises. Commencement information will
be e-mailed to your LSUE Student e-mail address prior to graduation. You are responsible for monitoring your LSUE student e-mail to ensure proper receipt of all
commencement information.
************************************************************************************************************************
BUSINESS AFFAIRS – OFFICE USE ONLY
OFFICE OF BUSINESS AFFAIRS
PROOF OF PAYMENT STAMP
DATE
PAID: _____________________
AMOUNT DUE: $45.00 or $20.00
METHOD OF PAYEMENT:
AMOUNT PAID: _____________________
Distribution:
R
egistrar Office – Original Business Office – Copy
(REVISED 11/29/2018)
Associate of Science in the Care & Development
of Young Children
Associate of Applied Science in Computer
Information Technology
Associate of Science in Criminal Justice
Associate of Science in Nursing
Associate of Applied Science in Diagnostic
Medical Sonography
Associate of Applied Science in Fire and
Emergency Services
Associate of Applied Science in Management
Associate of Applied Science in Surgical
Technology
Associate of General Studies
Associate of Arts (LT) Business
Associate of Arts (LT) Criminal Justice
Associate of Arts (LT) Fine Arts
Associate of Arts (LT) Humanities
Associate of Arts (LT) Mass Communication
Associate of Arts (LT) Social Sciences
Associate of Science (LT) Biological Sciences
Associate of Science (LT) Physical Sciences
Associate of Science in Radiologic Technology
Associate of Science in Respiratory Care
Return to:
Cash
Check or Money Order
Receipt No: _____________________
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App-deg LOUISIANA STATE UNIVERSITY AT EUNICE

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Completed 2 July 2020

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