Graduation Application for Former HCC Students
Please complete, sign and return this release form to:
Howard Community College
Office of Admissions and Advising
10901 Little Patuxent Parkway
Columbia, MD 21044
Attn: Graduation Advisor
Fax: 443-518-4589
completion@howardcc.edu
HCC Student ID Number: _________________ Desired Area of Study/Learning Program at HCC:____________________________
By signing this agreement you grant HCC permission to:
• Reactivate your record, if it has been more two years since you last attended
• Update your address and email, if it has changed
• Change your learning program and/or catalog year to one that allows you to graduate, if you have not met the
requirements in the HCC area of study/learning program indicated above
• Evaluate transcript(s) and transfer applicable credit to complete your degree
Please list the college(s) you will be providing official transcripts from:
________________________________________________________________________________________________
You must request official transcripts from the above college(s). Documents may be authenticated with the provider of the transcripts; forged and altered documents
will be subject to HCC’s Student Code of Conduct and the judicial process under Maryland State Law.
Clearly print name as it should appear on diploma or certificate (legal name only; no titles; indicate punctuation):
____________________________________________________________________________________________________________
First Middle Last
Full Legal Name: ______________________________________________________________ Date of Birth: ____________________
List any former names:_________________________________________________________________________________________
Mailing Address: ______________________________________________________________________________________________
City: _______________________________ State: ________ Zip Code: _____________ Phone: _____________________________
Email:______________________________________________________________________________________________________
May we send confidential student information to the email address noted above? Yes No
FERPA Statement
FERPA (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds
under an applicable program of the U.S. Department of Education. In accordance with FERPA, it is the policy of HCC to withhold certain educational records unless
the student provides consent to disclose information. The purpose of this form is to provide the consent to HCC as required by FERPA.
I, the undersigned, hereby understand and authorize HCC to perform a credit evaluation of my classes at HCC as well as classes completed at the above noted
college(s) to award a degree or certificate, if I am eligible to graduate.
This release does not permit the disclosure of these records to any other persons or entities without my written consent or as permitted by law. This release form is
effective from the date of signature below and consent remains in effect until receipt of written revocation.
_________________________________________________
Student Signature Date
For more information please go to: www.howardcc.edu/reversetransfer
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