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:
LMC DA Units:
Units in Progress:
Total Units:
Tot Units
Cum GPA
Honors
12 units
Approved
Denied
Evaluator
Date
Final GPA:
Posted to Transcript:
Diploma Sent: