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
_________________________________________________________
_________________________
_________________________
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
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome