Revised 3/9/10
Admissions & Records Office
APPLICATION FOR GRADUATION
Name (
Please Print):__________________________________________________________________________________
Last First Middle
Student ID _____________________________ Date of Birth: ________________________ Male Female
Other Names Used: ________________________________________________________________________________
Address to which diploma or certificate should be mailed. Check box to update your records to the address listed below
_________________________________________________________________________________________________
Number and Street City, State Zip Code
Email address: ______________________________________________ Day Phone: (______)
_____________________
Graduation for the end of: Summer _______ Fall_______ Spring _______ Year____________
Please note:
you may only submit application in the term you will be completing your requirements.
Application for: AA degree _______ AS degree ________ Certificate of Achievement ________
LMC Major _____________________________________________________ Catalog Year ______________________
(Must be listed in LMC catalog) (Refer to the information on catalog rights.)
2
nd
Major ___________________________________ 3
rd
Major____________________________________________
** CSU Transfer AA/AS path _____ ** IGETC Transfer Path CSU _____ or UC_____
**If you are using the transfer path, a copy of your acceptance letter must be submitted in order to post your transfer path
AA/AS degree.
Other colleges attended: _____________________________________________________________________________
(Official transcripts must be on file before this application will be accepted)
I will participate in the graduation ceremony. Yes________ No________
Print your name exactly
as it is to be shown on your diploma or certificate: Please print legibly.
_________________________________________________________________________________________________
First Middle Last
I authorize my name and honors to be published in the Commencement Program Yes No
♦ If the box is marked ‘yes’ or left blank, your name will be printed in the program.
♦ If the box marked ‘No’, your name will not be printed on the program.
Please check appropriate box:
Transferring to CSU or UC EOPS Student DSPS Student Honors Program
Signature: ____________________________________________________ Today's date: ________________________
Office Use Only:
