Fillable Application For Graduation Application for Baccalaureate Degree

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Application For Graduation Application for Baccalaureate Degree

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Country of origin: US
File type: PDF

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Application for Graduation
Semester and year in which you plan to COMPLETE degree:
December 20___ May 20___ August 20___
Do you plan to attend the Commencement ceremony? Yes ______ No ______
I understand that participation in commencement ceremonies does not mean that I have
graduated and that I am obligated to complete all degree requirements.
Student’s Signature: _____________________________________
Full Name
(please print or type your name as it is to appear on your diploma)
CCSU ID Number:
________________________________________________
____________________________
(first) (middle) (last)
Permanent Address:
________________________________________________
Your full-time occupation/title: _____________________
(street)
________________________________________________
Employer: ______________________________________
(city) (state) (zip)
If married, name of spouse: ________________________
Phone: Home: ( ) ____________________
Is spouse a CCSU Graduate? _______________________
Work: ( ) ____________________
If yes, year of graduation: __________________________
Cell: ( ) ____________________
Email: __________________________________
Degree Program: (circle one)
Campus Activities: Include the extracurricular activities
BA BS BFA BS-ED BSN
in which you are participating (including intercollegiate
athletics) and offices held:
Major: _________________________________________
1. _____________________________________________
2. _____________________________________________
Concentration: ___________________________________
3. _____________________________________________
Minor: _________________________________________
4. _____________________________________________
Return to:
Office Use Only:
Registrar’s Office
Matric Date. _______ Major/Minor Date: ______
(Admit Term) (Catalog Term)
Central Connecticut State University
Davidson Hall, room 116
Eval.: __________ Initial Eval.: ___________
1615 Stanley Street
New Britain, CT 06050
Lang. Req. _______________________ (rev. 10/06)
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Application For Graduation Application for Baccalaureate Degree

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Completed 13 February 2020

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