SIMMONS UNIVERSITY
Office of the
Reg
i
str
a
r
300 The Fenway, Boston, MA 0
2
115
Tel 617.521.2111 Fax
617-
5
2
1.314
4
registrar@simmons.edu
DUAL DEGREE AWARD DETACHMENT
Student should complete this form to petition for different conferral dates for the degrees in LIS Archives
and History. Students completing this form must have completed all the requirements for one program
and made significant progress in the other.
To ensure that all records are up to date, Simmons requires students to obtain the permission of both
program directors involved in the dual degree.
Students not intending to complete both halves of a dual-degree program should not use this form.
Stu
den
t Name
: ________________________________ Si
mmo
n
s
I.D: ______________________
E
-ma
il
A
ddr
ess
:
Pho
n
e Number
: ______________________
Intended conferral date of Archives Degree (MSLIS): May/Year_______
August/Year________
October/Year_______
January/Year_______
Intended conferral date of History Degree (MA): May/Year_______
August/Year________
October/Year_______
January/Year_______
Signatures:
Student’s Signature: __________________________________ Date: _______
LIS Archives Program Director: _________________________ Date: _______
History Program Director: ______________________________ Date: _______
Student Financial Services Counselor: ____________________ Date: _______
Please return completed form to the Office of the Registrar.
OFFICE USE ONLY: Processed Date _____ Initials _____ 08/2018
click to sign
signature
click to edit
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