________________________________________________________________________
SOMERSET COMMUNITY COLLEGE
GRADUATION APPLICATION
Summer 2020 ______ Fall 2020 _______ Spring 2021 _______
(Last day to apply April 3, 2020) (Last day to apply September 14, 2020) (Last day to apply February 5, 2021)
Thank you for applying for your credential (degree/diploma/certificate) from Somerset Community College. You are considered a
candidate for the credential until the audit process has been successfully completed. This does not necessarily indicate that your
credential will be awarded; it simply indicates that you have applied for a credential to be awarded by Somerset Community College.
Directions: (A) Please complete, sign and date this application. (B) Obtain your advisor’s signature and have your advisor attach a
program plan checklist. (C) Complete the Student Exit Survey. The web address for the survey is:
https://survey.somerset.kctcs.edu/blue/a.aspx?l=39_2_AAAAAAAAAaY. You will use your KCTCS user name and password to log in to
the survey. (D) Return the completed application to the SCC Student Records Office.
Name___________________________________________________________________________________________
Empl ID#__________________________________ Phone Number_________________________________________
Program Major___________________________________________________________________________________
Advisor’s Name _______________________________Advisor’s Signature___________________________________
Last Date Attended Classes at SCC ____________________________
Mailing address for credential _______________________________________________________________________
(Address)
(City, State, Zip)
Name to be printed on credential______________________________________________________________________
(Please print clearly)
Please list all credential(s) you are requesting:
___Associate in Arts
___Associate in Science
___Associate in Applied Science Major__________________________________________________________
___Diploma Title___________________________________________________________
___Diploma Title___________________________________________________________
___Certificate Title___________________________________________________________
___Certificate Title___________________________________________________________
___Certificate Title___________________________________________________________
___Certificate Title___________________________________________________________
___Certificate Title___________________________________________________________
___Certificate Title___________________________________________________________
___Certificate Title___________________________________________________________
___Certificate Title___________________________________________________________
By signing this application, I give the college permission to award embedded credentials within my program.
I give permission for SCC to release my contact and credential information to potential employers. ___YES ___NO
Student’s Signature_____________________________________________ Date_____________________________
IF YOU HAVE QUESTIONS CONTACT THE SCC REGISTRAR’S OFFICE: 606-451-6637 or 1-877-629-9722
click to sign
signature
click to edit
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