CLARK ATLANTA UNIVERSITY
OFFICE OF THE UNIVERSITY REGISTRAR
223 JAMES P. BRAWLEY DRIVE, SW
ATLANTA, GEORGIA 30314
UNDERGRADUATE APPLICATION FOR GRADUATION
Select Type of Degree: ___________________________________________
STUDENT INFORMATION
NAME (As it should appear on your Diploma - Name must be listed in BANNER)
STUDENT ID# 900
DIPLOMA ADDRESS (If different from Local Address)
CONCENTRATION (If Applicable)
___________________________________________ ________________
Student’s Signature Date
**DO NOT WRITE BELOW THIS LINE: ACADEMIC DEPARTMENT AND REGISTRAR’S OFFICE USE ONLY**
ACADEMIC INFORMATION PLANNING SCHEDULE (Last three (3) semesters)
SEMESTER COURSE(S)
SEMESTER COURSE(S)
SEMESTER COURSE(S)
__________________________________________ ______________ _______________________________________
Department Chairperson
Signature of Department Chair Date
REGISTRAR’S OFFICE USE ONLY:
TOTAL HOURS COMPLETED_______ HOURS OUTSTANDING_______
CUM. G.P.A._______ Graduation Fee ($200) Paid: Yes No
Approved Pending Not Approved
Signature Registrar's Staff: ______________________________ Date:________________
Expected date of graduation:
________________ ___________
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