Intent to Graduate
June 2021
Students planning to complete their degree or certicate requirements in the Spring term must complete and submit this form to the Registrar's Oce no later
than the deadline above. The degree conferral date is June 6, 2021. You will not graduate if we do not receive this form.
The Bursar will apply a $125.00 graduation/degree processing fee to students with a June anticipated graduation date. This is a one-time fee per conferral.
Do not include payment with this form, as the Registrar's Oce does not process payments.
Last name _________________________________________ First name _________________________________ Middle name _________________________
Phone __________ _________________________ Academic Advisor __________________________________________________________________
Academic program
Check one:
Bachelor of Arts
Bachelor of Science
Certicate (other than CAGS)
Master of Education
Master of Management
Master of Science
Major / Certicate Title __________________________________________________________________
Career credits required __________________ Career credits earned________________________
Transfer credits (if applicable) _____________ Credits enrolled this term________________________
Will you begin a new Cambridge College degree program next term? Yes No
Do you have any approved course waivers or substitutions? If so, please list course numbers below:
Student signature
on paper printout or electronic* ______________________________________________________
Date _____________________________________________________________
*Please see electronic signature options on the Registrar's web page
Degree seeking students only:
Name as you would like it to appear on your diploma.*
You must provide your legal name only as dened by Social Security. Your name will be printed on your diploma
or certicate as you see it when you log in to MyCC, so if you need us to change your name in the College
database, please show us legal documents proving the name change. Acceptable documents include marriage
certicate, divorce decree, and change of name petition.
After completing form submit it to:
Registrar's Oce
Cambridge College
500 Rutherford Avenue
Boston, MA 02129
Or email to:
Or fax to:
Registrar's Oce
Cambridge College
500 Rutherford Avenue
Boston, MA 02129
Phone: 617.873.0101
Fax: 617-242-0026
Form must be received by February 15, 2021
rev. 12/10/20
Student ID#________________________
Your Cambridge College Location
Puerto Rico
Southern California
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