Fillable Certificate Of Ed Specialist App For Degree

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Certificate Of Ed Specialist App For Degree

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The Certificate Of Ed Specialist App For Degree form is 2 pages long and contains:

  • 2 signatures
  • 5 check-boxes
  • 31 other fields

Country of origin: US
File type: PDF

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LSU | Graduate School
Page 1 of 2 Updated
3/2019
Certificate of Education Specialist Application for Degree
Email submission to gradsvcs@lsu.edu.
Student Information:
Degree Only Registration: Yes No
Name:
(
See Catalog for requirements)
LSU Student ID:
LSU Email:
Phone:
Education
Degrees Held (Include institution and year):
Major
Field:
Semester/ Year of Graduation:
Department:
Diploma Information: (Type or print the name you want to appear on your diploma.)
First Name:
Middle Name:
Last Name:
Hometown:
Home State:
Parish/County:
Country:
By signing below, I acknowledge that I understand that the name provided above will appear on my
diploma.
Sign
ature: Date:
Diplo
ma Distribution:
I will attend the ceremony.
I will pick up my diploma from 112 Thomas Boyd Hall after commencement.
I would like my diploma mailed to:
LSU
will NOT deliver to local addresses, (i.e.) Baton Rouge and the immediate surrounding
areas. Diplomas will be mailed approximately two weeks after commencement.
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signature
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LSU | Graduate School
Page 2 of 2 Updated
3/2019
Certificate of Education Specialist Degree Audit
Email submission to gradsvcs@lsu.edu.
LSU Student ID: Name:
NOTE: The program for the Certificate of Education Specialist is a 60-63 hour program. All 60-
63 hours must be listed on this form. List each course and number of hours associated. (Ex: EDCI
7610 (3))
Coursework Information:
List all relevant LSU courses and hours required towards this certificate.
(Ex: EDCI 7005 (3), EDCI 7930 (6))
Courses Completed at LSU:
Courses Transferred or Petitioned (list institution and date taken) Hours Completed:
Courses Remaining: Hours Remaining:
Required Signatures:
Student: Date:
Committee Chair: Date:
Committee Member: Date:
Committee Member: Date:
Graduate Program Advisor: Date:
D
ean of the Graduate School: Date:
For Office Use Only:
GPA: Reg: CW: Time:
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Certificate Of Ed Specialist App For Degree

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Completed 14 May 2020

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