I hereby acknowledge by signing this document of application to SUNY Erie Community College that I will be held personally
and legally responsible for any debts or liabilities incurred at the institution. Financial obligations may include all tuition
liabilities, fees, books, child care and other extraneous costs. If legal action must be taken for restitution, I will be responsible
for all collection and legal costs.
Signature: _____________________________________________ Date: __________________
SECTION III: FOR OFFICIAL COLLEGE USE ONLY
To Be Completed by Academic Department
GRADUATE'S CURRICULUM (MAJOR):
CHECK ONE: CERTIFICATE DEGREE: AAS AA AS AOS
Certified as meeting preliminary requirements pending review and successful completion of current semester courses, as well as
meeting all other requirements for the curriculum as listed in the catalog.
(CURRICULUM COORDINATOR/DEPARTMENT HEAD SIGNATURE)
To Be Completed by Registrar
Date Received: Initials:
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