RECORDS AND REGISTRATION USE ONLY:
Office of Records and Registration
Winthrop University
126 Tillman Hall
Rock Hill, SC 29733
Phone: 803/323-2194
FAX: 803/323-4600
GRADUATE SCHOOL APPLICATION FOR GRADUATION
Please print clearly or type all information requested. Submit this completed application according to the deadlines below. Diploma orders are based
on the information provided on this form. Students receiving a degree may be included in lists provided to local and other news media for publica-
tion. Students wishing their names to be withheld from publications must submit a written request to the Office of Records and Registration at least
one month prior to the commencement exercises.
*
D
eaDline for
G
raDuate
S
tuDentS
-
completed form due in the Office of Records and Registration, 126 Tillman, by
F
ebruary
1
for May and August graduates, and
S
eptember
15
for December graduates. Failure to submit an application by this deadline will
result in a $25.00 late fee and may result in a delay in obtaining your diploma.
**G
raDuation
f
ee
-
A $50 graduation fee will be charged to your student account. Please do not enclose this payment when submit-
ting your Application for Graduation.
Graduation term: May August December
Student Number
Year Year Year
Participation in commencement is contingent upon the completion of all requirements for the degree. Commencement exercises are
held in December and May. Do you plan to participate in commencement exercises? (Circle one) Yes No
Name on Winthrop record:
Last First Middle Suffix
Address:
Street City State ZIP
Telephone:
Daytime Evening E-mail Address
Name to appear on diploma:
First Middle Last Suffix
Undergraduate information:
Degree College/University
Hometown to be listed in the newspaper:
City County State Country
Graduate Degree/Major Option/Area of Concentration Adviser
Student Signature Date
4/2017
