04/2019 S:\grad\FORMS\Updated Forms\Intent to Graduate-Fillable
For Graduate College Use Only: Student Acct Charged $________________
Date:______________
INTENT TO GRADUATE
Deadline to Submit: June 1 (August graduation); August 1 (October graduation); October 1 (January graduation); February 1
(May graduation)
Instructions:
1. Complete and save this form as a PDF
2. Submit the form via e-mail attachment to the Graduate College at gradcoll@uvm.edu WITH A CC: TO YOUR
ADVISOR
AND YOUR DEPARTMENT CONTACT
3. Advanced Degree Fees will be charged to your student account upon receipt at the following rates:
Certificate-$10; Master’s - $20; Doctoral - $35
NAME AS YOU WANT IT TO APPEAR ON YOUR DIPLOMA and in the Commencement Program:
_____________________
______________________________________________________
Please write your name pronunciation for the Ceremony : _________________________________________________________
UVM STUDENT ID NUMBER: ___________________________
PERMANENT A
DDRESS: _____________________________________________________________________________________
Street Address City State Zip Code
Your diploma
will be mailed if you do not attend the ceremony; please update your address with the Registrar’s Office as well.
____________
___________________________________
Non-UVM Email Address
WRITING
A: Dissertation
(Select one) Thesis
Non-Thesis
________________________________________________
UVM Email Address
DEGREE:
(Select one)
PROGRAM_______________________________
GRADUATION TERM: YEAR: ____________
DATE COMPREHENSIVE EXAMS WERE COMPLETED: ___________________
PREVIOUS DEGREES
EARNED (Ex: BA, MEd, AS, etc.):
__________________
Year
__________________
_________________
Degree
_________________
Degree
____________________________________________
College or University Name
____________________________________________
College or University Name
Year
HOMETOWN (City and State/City and Country):__________________________________________ (for Commencement Program)
GPA: ____________ Advisor Name: ______________________________________________
Program Coordinator/Director Name: ________________________________
May
August
October
January
NAME IN THE UVM SYSTEM- FIRST NAME: LAST NAME:
I acknowledge that upon receipt of this form, an Advanced Degree Fee will be charged to my UVM account
