ApplicationforGraduation(5-26-2020)
Office of Admissions & Records
Application for Graduation
If you do not know the Associate Degree(s) or catalog year you should follow, please schedule an appointment with a counselor
or educational advisor by calling (909) 346-3717 or (626) 387-3930 or by visiting our website at www.mtsac.edu/counseling.
CATALOG YEAR: ____________________
I PLAN TO GRADUATE (please indicate a term/year):
SUMMER _______ FALL _______ WINTER _______ SPRING _______
YEAR YEAR YEAR YEAR
Name: __________________________________________________________________________________
Last Name First Name Middle Name
Student ID: A__________________________ Phone Number: _____________________________
DEGREE INFO (major codes are available on the reverse side of this form):
Degree ADT AA AS
Major Title: ________________________________________________ Major Code: _______________
Degree ADT AA AS
Major Title: ________________________________________________ Major Code: _______________
Degree ADT AA AS
Major Title: ________________________________________________ Major Code: _______________
Note: Sixty (60) Degree Appropriate Units are required for the initial degree.
List the College(s) attended and submit all official transcripts considered necessary to satisfy any graduation
requirement(s). Official transcripts must be on file when submitting your application for graduation.
1._____________________________________ 2._____________________________________
3._____________________________________ 4._____________________________________
YES NO
Do you have College Board AP or Baccalaureate IB forms on file?
Have you filed a Petition for Exceptional Action for graduation?
Do you have any variances for courses in your major?
Do you have any military transcript on file?
Are you currently enrolled at another college?
If “YES”, please complete the table below:
By participating in Commencement, I grant permission to Mt. San Antonio College, its employees and agents, to take and use visual/audio images of
me at Commencement. I agree that Mt. SAC owns the images and all rights related to them. The images may be used in any manner or media without
notifying me. I waive any right to inspect or approve the finished images or to be compensated for them. I release Mt. SAC and its employees and
agents from any claims, damages or liability which I may ever have in connection with the taking and use of the visual/audio images.
I understand it is my responsibility that official documents are on file and/or attached to process this graduation application.
Signature:_______________________________________________________________ Date: _____________________
*** Please Save Form with a Different File Name ***
