Durham Technical Community College
Graduation Application
Print your name exactly as you want it to appear on your diploma:
Last name: __________________________ First name: _______________________ MI: _____________
Address: ______________________________ City: ____________ State: ________ ZIP: ______________
Durham Tech Student ID# __________________________ Email________________________________
Phone: Home: ___________________ Business: ___________________ Cell: ___________________
Student Signature________________________________________________ Date__________________
The foll
owing information is needed for state and federal reporting purposes (check one in each category):
Gender: Female Male Ethnicity: White Black American Indian
Hispanic Asian Other________________________
Complete the Following Information:
Program of study: Check program(s) on the next page.
I expect to graduate in (semester and year) ______________________________
The semester and year indicated above must be your final semester of coursework. You are encouraged to meet with your
academic advisor to make sure you will be eligible for graduation. If you change your address after the end of your final
semester, please inform student information and records of your change of address.
I plan to participate in commencement (graduation):
Yes
No Commencement is held each May.
I want to receive the official copy of degree,
diploma or certificate.
Student Information and Records
Durham Technical Community College
1637 Lawson Street
Durham, NC 27703
If you’re on campus, deliver this form to:
Student Information and Records
Wynn Center, room 10-201
For Student Records Use ONLY
Plan of Study/Year______________________
________________Preliminary audit by
________________Date entered in
Colleague
________________Preliminary GPA
_______________Final audit by
_______________Date entered in
COLLEAGUE
_______________Graduation date
_______________Graduation GPA
Diploma/Certificate/Degree:
Date ordered___________________
Date distributed_________________
Revised 9/2018
click to sign
signature
click to edit
ASSOCIATE DEGREES
C60160E Automotive Systems Technology - Electrical Certificate
A25800 A
ccounting and Finance*
A
45330 A
nesthesia Technology*
A40100 Architectural Technology*
A
45110
Nursing*
A45110N Nursing: LPN to AND Track
*
A
10100 A
ssociate in Arts
A
10500 A
ssociate in Engineering
A10600 Associate in Fine Arts in Visual Arts
A
10300 A
ssociate in General Education
A
1030N A
ssociate in General Education - Nursing
A
10400 A
ssociate in Science
A
60160 A
utomotive Systems Technology*
A50100 Biomedical Equipment Technology*
A
25120 B
usiness Administration*
A
45190 C
linical Trials Research Associate*
A
55180 C
riminal Justice Technology*
A
45280 D
ental Laboratory Technology*
A55220NT Early Childhood Education - Non-Transfer*
A55220TR Early Childhood Education - Transfer
*
A
35130 E
lectrical System Technology*
A
40200 E
lectronics Engineering Technology*
A
55460 E
mergency Management*
A45340 Emergency Medical Science*
A
55240 F
ire Protection Technology*
A
45360 H
ealth Information Technology*
A
25110 H
ospitality Management*
A50240A Industrial Systems Technology - Advanced Manufacturing
*
A50240F Industrial Systems Technology - Facilities Maintenance Tech
*
A25590A Information Technology - IT & Cloud Systems Administration
*
A25590H Information Technology - IT and Network Support
*
A25590N Information Technology - Network Security
*
A25590S Information Technology - Software Development*
A25590W Information Technology - Web Development
*
A
45400 M
edical Assisting*
A
25310 M
edical Office Administration*
A
45810 M
edical Product Safety and Pharmacovigilance*
A45500 Occupational Therapy Assistant*
A
25370 O
ffice Administration*
A
45560
Opticianry*
A
25380 P
aralegal Technology*
A
45580 P
harmacy Technology*
A
45720
Respiratory Therapy*
*Associate in Applied Scienc
e
DIPLOMAS
D25380 Paralegal Technology
D
60160 A
utomotive Systems Technology
D55370M Community Spanish Interpreter - Medic
al
D55370F Community Spanish Interpreter - Public Servic
e
D
50210
Computer-Integrated Machining
D55180 Criminal Justice Technology
D
35130 E
lectrical System Technology
D25590I Information Technology - IT Administratio
n
D25590S Information Technology - Software Developmen
t
D25590W Information Technology - Web Developm
ent
D45400 Medical Assisting
D
45970
Nurse Aide
D
45580 P
harmacy Technology
D
45660 P
ractical Nursing
D
45740 S
urgical Technology
CERTIFICATES
C25800B Accounting and Finance - Bookkeeper Entrepreneur Certificate
C25800I Accounting and Finance - Income Tax Preparer Certificat
e
C25800P Accounting and Finance - Payroll Agent Certificat
e
C40100C Architectural Technology - Architectural CAD Certificat
e
C60160D Automotive Systems Technology - Drivetrain Certificat
e
C60160M Automotive Systems Technology - Machining Certificat
e
C60160U Automotive Systems Technology - Under Car Certificat
e
C55120 Basic Law Enforcement Training Certificate
C25120A Business Administration - Business Core Certificat
e
C25120C Business Administration - Hotel Management Certificat
e
C25120H Business Administration - Human Resources Mgmt Certificate
C25120B Business Administration - Management Certificat
e
C25120M Business Administration - Marketing Certifica
te
C45190II Clinical Trials Research Associate - Advanced Topic
s
C45190I Clinical Trials Research Associate - Core Competencie
s
C45190MC Clinical Trials Research Associate - Data Management
C55370M Community Spanish Interpreter - Medical Certificat
e
C55370F Community Spanish Interpreter - Public Service Certificat
e
C50210M Computer-Integrated Machining - Basic Machining Certificat
e
C50210C Computer-Integrated Machining - CNC Certificat
e
C
55180 C
riminal Justice Technology Certificate
C45280P Dental Laboratory Technology - Cast Partial Dentur
e
C45280T Dental Laboratory Technology - Complete Denture Techniques
C45280B Dental Laboratory Technology - Crown and Bridge Techni
ques
C45280C Dental Laboratory Technology - Dental Ceramic Techni
ques
C55220A Early Childhood Education - Administration Certificat
e
C55220C Early Childhood Education - Child Development Certificat
e
C35130B Electrical System Technology - Construction Electrician
C35130C Electrical System Technology - Control Electricia
n
C35130M Electrical System Technology - Maintenance Electrici
an
C40200R Electronics Engineering Technology - Computer Repai
r
C55460B Emergency Management - Business Continuity Certificat
e
C25490 Entrepreneurship Certificate
C55240S Fire Protection Technology - Fire Inspection Certificat
e
C55240M Fire Protection Technology - Fire Management Certificat
e
C25110E Hospitality Management - Event & Meeting Planni
ng
C50240C Industrial Systems Technology - HVAC Certificat
e
C50240M Industrial Systems Technology - Maintenance Certificate
C
55290 I
nfant/Toddler Care (Certificate)
C25590A1 Information Technology - Cloud Management Certificat
e
C25590S1 Information Technology - Database Programming Certificat
e
C
25590 I
nformation Technology - IT Foundations Certificate
C25590SJ Information Technology - Java Developer Certificate
C25590S2 Information Technology - Microsoft Developer Certifica
te
C25590NC Information Technology - Secure CCNA Certificat
e
C25590S Information Technology - Software Development Fundamental
s
C25590W1 Information Technology - Web Developer Certificat
e
C25590W Information Technology - Web Development Fundamentals
C45810S Medical Product Safety and Pharmacovigilance Certificat
e
C
25370 O
ffice Administration - Administrative Office Certificate
C
45520 O
ptical Apprentice (Certificate)
C25380D Paralegal Technology - Bankruptcy Law Certificat
e
C25380B Paralegal Technology - Business Law Certificate
C25380C Paralegal Technology - Civil Litigation Certificat
e
C
50420 W
elding Technology - Certificate
Other not listed
C
ode: ____________________________________
Name: ____________________________________
Refer to diplomas, degrees and certificates offered by the college prior to
2017 if the program code and name is not included in the list above.
Please write the program code and program name on the line above.
Revised 9/2018
Durham Tech Graduate Satisfaction Survey
Congratulations from Research, Evaluation, Assessment, and Planning (REAP) on your
upcoming graduation. We applaud you and your accomplishments, and wish you all the
best in your future endeavors.
We’d greatly appreciate your feedback about your experiences at Durham Tech. Your
opinions are highly valued and needed for measures of assessment and improvement.
Please complete the Durham Tech Graduate Satisfaction Survey
.
If you questions about the graduate survey, please contact Melanie Riester at
919-536-7249, ext. 2804 or via email at riesterm@durhamtech.edu
.
I
f you have any questions about graduation, please contact Jacquelyn McKeithan-Foster at
919-536-7214, ext. 1804 or via email at mckeithj@durhamtech.edu
.
T
hank you very much!
Revised 9/2018