March 2016 University Registrar
CERTIFICATE OF COMPLETION REQUEST
Use this form to request a certificate of completion for certificate programs only. (Do not use it to apply
for graduation from a degree program.) Please allow four to six weeks following the completion of the
program’s requirements for delivery.
Submit form to: Golden Gate University, Office of Records and Registration, 536 Mission Street, San
Francisco, CA 94105-2968; or fax it to 415-442-7223; or e-mail a scanned copy to graduation@ggu.edu.
If you are uncertain about the exact requirements or title of the certificate you are seeking, please consult
with your academic advisor, or the catalog for the academic year you began the program.
GGU ID Number/SSN: _______________________ Date of attendance: ________ ________
month/year to month/year
Name on GGU Academic Record:
____________________________________________________________________________________
last (family/legal) name first (given) name middle name or initial
Name as you would like it to appear on your certificate (please print or type):
____________________________________________________________________________________
NOTE:
If you wish to have your certificate issued in a name which differs from that in our academic records, you
must attach documentation verifying a legal name change (for example, a photocopy of a marriage certificate, etc.)
Address where you want certificate mailed:
____________________________________________________________________________________
Street
____________________________________________________________________________________
City State Zip code Country
Daytime Phone: _______________________________ Email: _________________________________
I am applying for:
Undergraduate Graduate Law School
Certificate Program: ___________________________________________________________________
I will complete all requirements by the end of the: Fall Spring Summer Year: ______
Student’s Signature: ________________________________________________ Date: ____________
This section is for only Golden Gate University use.
Date received: _________ Initials of receiver: _________________ Date mailed: _____________
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