Application for Graduation
Please complete the entire form, save a copy for your records, and email the form to records@gtcc.edu.
Please submit one application for each award requested. By submitting this request, you understand
that you must complete all requirements pertaining to your degree program as specified by the Catalog.
___________________ _________________________ _________________________ _____________
First Name Middle Name Last Name Maiden Name
_____________________________________________ ______________________________________
Phonetic Spelling of Name Name as you would like it to appear on your degree/diploma
_____________________________________________ _______________________________________
GTCC Student ID Number or Last Four Digits of Social Security Number Date of Birth
_____________________________________________ ___________________ ______ _____________
Address City State Zip
_____________________________________________ _______________________________________
Cell Phone Number Alternate Phone Number
_____________________________________________ _______________________________________
GTCC Email Personal Email
□ I would like to have my permanent record updated to include the name and address on this application.
I am applying for a: □ Degree (Two-year) □ Diploma (One-year)
In (Program Name): ____________________________________________________________________
(Program Code): ____________________________________________________________________
Records Processing Center
SGRD Entry: ______________________________
Appl. Entry: ______________________________
GPA: ____________________________________
Grad: ___________________________________
DOD Entry: _______________________________
Print Date: _______________________________
