Application for Graduation
Associate Degree and/or Certiﬁcate
Please complete this application with an Academic Adviser, Room A102. The adviser will complete the initial graduation audit of your academic
record. The following submission deadlines are applicable:
a) For May Graduates participating in the commencement ceremony, form must be received by March 1.
b) For May Graduates not participating in the ceremony, form must be received by May 1.
c) For August Graduates, form must be received by August 1.
d) For December Graduates, form must be received by December 1.
Please keep your contact information current with the records oﬃce until you receive your diploma.
1. Print your name exactly as you want it to appear on your diploma or certiﬁcate. Full legal name is customary. This is also the name that
will appear in the commencement program and announce you as you cross the commencement stage (if you participate).
2. Student ID #: _______________________________________Birthdate: ____________________________________________
Email Address: __________________________________________________________________________________________
3. Mailing Address: _________________________________________________________________________________________
City: _____________________________________________State: _____________________ Zip: _______________________
4. Home Phone: ______________________________________Cell Phone: ___________________________________________
5. List the catalog year and program of study that govern your graduation requirements (copy from your degree audit):
Catalog Year: ______________________________________Program of Study: ______________________________________
6. Please check the semester and indicate the year in which you expect to graduate. You must complete the degree
and/or certiﬁcate requirements before this date.
O May, ___________ (year); O August, ___________ (year); O December, __________ (year)
7. The college has one graduation ceremony each year, which is held in May. Degree recipients are eligible to attend. Please check one of
O Yes, I will participate in the May graduation ceremony.
O No, I will not participate in the May graduation ceremony.
8. If you checked yes to question 7, please complete the following information which will be used to order your cap and gown:
Height: ______________ feet , ______________ inches Weight: ______________ lbs
Note: Garb (approximately $25.00) must be purchased by all ceremony participants.
9. All graduates are customarily listed in the commencement program and in a newspaper announcement. If you do not want your name
printed in the program and included in the newspaper announcement, please initial: _________
By signing this application, I aﬃrm that I have read and understand the college’s graduation requirements as set forth in the current college
catalog. In addition, I understand that this application will be used solely for the term indicated. If the ﬁnal graduation evaluation determines that
I am not eligible for the degree and/or certiﬁcate in the term which I have indicated, I understand that I must ﬁle a new application in a future
term. I also understand that the ceremony will be videotaped for duplication and replay on cable television. I agree to the terms on the reverse of
Student’s Signature: _____________________________________________________________ Date: ______________________
1601 Washington Road | Westminster, MD 21157 | carrollcc.edu