Reference Columbia State Policy 02:02:00
Revised 6/18
_________________________________________________________________________________________________________________
INTENT TO GRADUATE
(For students seeking a degree)
1. Eligibility and Instructions for completing this form:
• Your earned hours and current classes must total at least 40 semester hours (not including learning support classes).
• You must be degree seeking (AA, AFA, AS, AST, or AAS). Technical certificate students complete the “Request for Technical Certificate.”
• Please complete EVERY ITEM or the processing of this form will be delayed and the form returned.
• DO NOT complete a Change of Major form – the major you list on this form becomes your new major.
2. PRINT YOUR NAME AS YOU WANT IT TO APPEAR ON YOUR DIPLOMA.
(This is also how your name will appear in the program and will be announced at the graduation ceremony.)
__________________
__________________ ____________________________________ ____________________________________
Last Name First Name Middle or Maiden Name (Optional)
3. Student ID Number: ____________________________________________
4. I will take my final courses for my degree the semester of: Fall 20____ Spring 20____ Summer 20____
5. I intend to complete the following degree(s) with Columbia State by the end of the semester indicated above.
(Place a check mark by degree(s) and write in the major or emphasis.)
_____ A.A. degree*, major in Tennessee Transfer Path, emphasis: _______________________________________________
*requires 6 semester hours of the same foreign language
_____ A.A. degree*, major in University Parallel, emphasis, if applicable: _________________________________________
*requires 6 semester hours of the same foreign language
_____ A.F.A. degree, major in Tennessee Transfer Path, emphasis: Music
_____ A.S. degree, major in Tennessee Transfer Path, emphasis: _______________________________________________
_____ A.S. degree, major in University Parallel, emphasis, if applicable: _________________________________________
_____ A.A.S. degree, major in _________________________ option, if applicable: _________________________________
_____ A.S.T. degree, major in Teaching (K-5)
_____ A.S.T. degree, major in Early Childhood Education (Pre K-3)
6. Have you previously been awarded a college degree? ___ No ___ Yes, what degree? ________________________
7. Spring completers who wish to participate in the May ceremonies must submit this form by the last Friday of
February. Summer or Fall completers who wish to participate in the December ceremony must submit this form by
the last Friday of September. To participate in the graduation ceremony, specify below.
_____ Yes, specify Height: ______ Weight: ______ (necessary to order academic robe)
_____ I am unable to participate in the ceremony.
8. Signatures are required: Students are required by the Tennessee Board of Regents and Columbia State to take an exit
exam that measures general educational achievement. The exam is free of charge and no minimum score is required for
graduation. Your signature indicates that you have read these statements and will register for and take the exit exam (you
will receive information about the exam by mail and it is contained within the online degree audit). To ensure that you have
completed 40 college credit hours and are indicating the correct degree and major/emphasis on the Intent, a signature from
a college official is required. Officials can include advisors, deans, academic division office staff, completion specialists, or
extended campus staff. The Official will forward the Intent to the Records Office or email to records@columbiastate.edu.
Student’s Signature: __________________________________________________ Date: ______________________
Of
ficial’s Signature: ___________________________________________________ Date: ______________________
9. On
ce the Records office completes processing, you will receive an email via your Columbia State email that will
include information about your Intent and other requirements.
Columbia State, a Tennessee Board of Regents institution, is an AA/EOE educational institution
