Fill - Free fillable Form 3.: Please PRINT legibly and fill in (Danville Area Community College) PDF form

APPLICATIONTOGRADUATE–DANVILLEAREACOMMUNITYCOLLEGE

Itmaytake3to4weeksforyourApplicationtobereviewed

Please PRINT legibly and fill in all blanks. Print your name exactly as you want it to appear on your diploma.

1.________________________________________________________________________________________________________

Last Name First Name Middle Name or Initial

2.________________________________________________________________________________________________________

Current Address or P.O. Box # City State Zip Code

Student I.D. # Phone Number Today’s Date Primary E-mail Address

. Will you be walking in our May Commencement Ceremony?............................. YES NO

Do you already have a cap & gown?.............................................................. YES NO

To order a cap & gown visit HerffJones.com/college/graduation Deadline is March 31

After March 31st,

you may purchase your cap & gown through the DACC Follett Bookstore up to April 30

*If we do not see you have a cap & gown, we will assume you are not walking.

5. Are you a Veteran or a current member of the Armed Forces? YES NO

. Are you a member of the Phi Theta Kappa (PTK) society? YES NO

. Indicate the semester and year (i.e., Spring 15) in which you will complete the courses for your degree:

Spring _______ Summer _______ Fall _______

______ Associate in Arts (AA) ______Associate in Science (AS) ______ General Studies (AGS) ______ Applied Science (AAS)

______Engineering Science (AES) _______Fine Arts in Art (AFA) ______Fine Arts in Art Education (AFAE)

. List major/area of study: Major:______________________________________

*******************************FOR DACC OFFICE USE ONLY********************************

_____ This student is currently eligible to graduate.

_____ This student is eligible to graduate pending completion of current courses.

_____ This student is eligible to graduate pending completion of ______________ semester courses.

_____ This student is not eligible to graduate due to the following deficiencies:___________________________________

___________________________________________________________________________________________________

*Please review for multiple degrees and/or certificates, if applicable.

______________________________________________ ________________________________________________

Advisor/Counselor Date Registrar/First Check Date

______________General Education Requirements Met(AAS degree only) __________________________________________________________________

Registrar/Final Approval Date

______________________________________________________________

Division Dean/Program Director Date

__________________________________________________________________

Initial GPA Honors Final GPA Honors

Letter Sent: __________Posted: __________ Diploma Sent: ____________

Excel:_________________________________________________________________Grad. Flag: __________________________D.C.___________________________

Fill Online, Printable, Fillable, Blank Form 3.: Please PRINT legibly and fill in (Danville Area Community College) Form