Revised 9/18/2018
Application for Graduation
□ Fall 20 □ Winter 20 □ Spring 20 Summer 20
STUDENT INFORMATION
CWID:
Tech E-Mail:
Permanent E-Mail:
NAME EXACTLY AS IT SHOULD APPEAR ON DIPLOMA
First Name:
Middle Name:
Last Name:
STUDENT CONTACT INFORMATION (after graduation)
Address:
City:
State:
Zip:
Home Town (City/State or COUNTRY) for Commencement Program:
Current Phone #:
Permanent Phone #:
ACADEMIC PROGRAM INFORMATION
(If you are receiving two degrees or if you are a double major, you must complete two separate applications)
Main Campus
Barksdale AFB
Online Program
Are you currently enrolled at another university? Check one: □ Yes □ No
If Yes, complete the following:
College/University Name:
Course(s) you are registered for:
Will you need assistance at graduation? Check one: □ Yes □ No
Will you attend the Commencement Ceremony? Check one: □ Yes No
If No, you must complete the Absent from Commencement form on https://www.latech.edu/registrar-office/
DEGREE CANDIDATES SIGNATURE DATE
Pending completion of this term’s coursework, this student is eligible for conferral of the degree listed above.
_____________________________________________________
DEPARTMENT HEAD
_________________________________________________________
_________________________
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DEAN OF COLLEGE
Please type ALL information. Handwritten applications are no longer accepted.
Return completed form to your designated college
DATE
DATE
click to sign
signature
click to edit