Fillable Certificate of Completion APPLICATION FOR Check List CERTIFICATE (Laramie County Community College)

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Certificate of Completion APPLICATION FOR Check List CERTIFICATE (Laramie County Community College)

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LARAMIE COUNTY
COMMUNITY COLLEGE
APPLICATION FOR
CERTIFICATE OF COMPLETION
INSTRUCTIONS: The Application for Graduation must be
submitted by the posted deadline for the semester you wish
to receive your degree/certicate. Please read carefully and
understand your responsibilities under this application. Submit
this form with the appropriate degree or certicate evaluation,
signed by your advisor, to the Student Hub.
Today’s Date: _______________
NAME: ____________________________________________________
(Print or type your name as you wish it to appear on your diploma)
STUDENT ID#: _____________________________________________
PHONE NO.: _______________________________________________
MAILING ADDRESS FOR DIPLOMA:
__________________________________________________________
Street Address or Box Number
__________________________________________________________
City State ZIP
NOTE: LCCC’s Commencement Ceremony is held in May. If you
complete your requirements and graduate in the Summer or Fall
semesters, you may and are encouraged to participate in
the ceremony.
PLEASE READ AND UNDERSTAND: Please accept this as my formal
application for graduation. I realize that I will receive a formal degree
check as a result of this application and that I am responsible for
completing requirements as specied in the letter.
Student Signature ___________________________________________
Date______________
Advisor’s Signature
__________________________________________
Date______________
CERTIFICATE SOUGHT:
Check one – a separate application and signed program
evaluation is required for each certicate.
Credit Diploma
Automotive Body Repair
Automotive Technology, Engine Management/Drivability
Automotive Technology, Under Car/HVAC
CIS Cybersecurity Fundamentals
CIS Cybersecurity Professional
CIS Ofce Applications Specialist
CIS Microsoft Systems and Networks
CIS Web Design
Cisco Certied Networking Associate (CCNA)
CIS, Computer Support Specialist
CIS, Datacenter Technician
Diesel Technology
Emergency Medical Services, Paramedic
Engineering Technology
Entrepreneurship
Entrepreneurship Business Plan
Equine Training
Exercise Science – Coaching
Exercise Science, Personal Trainer
Heating, Ventilation and Air Condit/Refrig Tech Basic
Heating, Ventilation and Air Conditioning/Refrig Advan
Industrial Maintenance
Medical Ofce Essentials
Surgical Technology, Central Sterile Processing
Welding Technology, Combination Welding
Welding Technology, Advanced Pipe Welding
Certicate
Paralegal
Nursing
Health Information Technology, Medical Claims Coding
PRS 9473Cert 9/18
Certificate of Completion
Check List
1. Print your degree audit in myLCCC.
2. Make an appointment to meet with
your advisor regarding your degree
audit and application.
3. Turn in signed degree audit and
application for Certificate of
Completion to the Student Hub.
I expect to Graduate in:
Spring (May)
__________ (yr)
Summer (July)
________ (yr)
Fall (Dec.)
____________ (yr)
2019
2019
2018
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Certificate of Completion APPLICATION FOR Check List CERTIFICATE (Laramie County Community College)

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Completed 4 February 2021

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