APPLICATION FOR UNDERGRADUATE DEGREE
MINNESOTA STATE UNIVERSITY MOORHEAD
Purpose: All candidates for a baccalaureate degree must declare their intent to graduate so the University acknowledges
and records all degrees, program majors and minors on the final academic record.
ALL REQUIREMENTS ON
YOUR DEGREE AUDIT MUST BE MARKED AS COMPLETE IN ORDER TO GRADUATE.
Deadline: If you are graduating: Submit completed form:
Fall Semester no later than the 1
st
week of September
Spring or Summer Semester no later than the third week of January
Submit completed form to:
Diploma Mailing:
Registrar’s Office, Owens Hall 210 -
Forms without Department signatures will not be accepted
A non-refundable $30 commencement fee will be required for students planning to participate
in the commencement ceremony.
Diplomas will be mailed about 2 months after the last day of the semester you graduate.
PRINT LEGIBLY AND COMPLETE IN FULL
I. Name: _____________________________________________________ Dragon ID: __________________________
The preferred name listed with the Registrar’s Office is how your name will appear on your diploma and in the commencement
program. If you wish to change this name, you must update your preferred name with the Registrar’s Office.
MSUM E-mail: _________________________________________________ Advisor: ______________________________________
Permanent Address (diplomas will be mailed to this address about 2 months after the last day of the semester you graduate):
________________________________________________________________ ________________________________________________
Street Address Hometown & State (to be listed in the Commencement Program)
______________________________________________________________________________
City, State & Zip
II. Semester and year you expect to complete all requirements (select one):
FALL SPRING SUMMER YEAR 20__________
Commencement – Do you plan to attend: Yes No Don’t Know
Degree: A.A. B.A. B.F.A. B.M. B.S. B.S.N. B.S.W. CERTIFICATE
College (select one):
Arts, Media & Communications Business & Innovation Education & Human Services
Humanities & Social Sciences Science, Health & the Environment
Major(s): 1_____________________________________ 2_____________________________________
Emphasis:
1_____________________________________ 2_____________________________________
Minor(s): 1_____________________________________ 2_____________________________________
Honors (students must earn a minimum of 45 MSUM resident credits):
Cum Laude (3.40 - 3.59) Magna Cum Laude (3.60 - 3.79) Summa Cum Laude (3.80 - 4.00)
III. __________________________________________________________ _____________________________
Student signature Date
__________________________________________________________ _____________________________
Academic Advisor signature Date
_____________________________________________________ _________________________________________________
FIRST MAJOR Department Chair signature Date SECOND MAJOR Department Chair signature Date
Departmental Request for
Course Exception Forms
need to be submitted to the Registrar’s Office. MINOR(S) do not require a department signature.
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