Fillable Worcester Polytechnic Institute Graduate Degree Completion Form (Worcester Polytechnic Institute)

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Worcester Polytechnic Institute Graduate Degree Completion Form (Worcester Polytechnic Institute)

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Worcester Polytechnic Institute
Office of the Registrar
Please submit completed form to the Office of the Registrar, First Floor Daniels Hall.
508-831-5211 (tel) 508-831-5931 (fax)
100 Institute Road, Worcester MA 01609-2280
wpi.edu/+registrar
dr:1/24/18
Graduate Degree Completion Form
*IMPORTANT: This form must be completed after applying for graduation and informing the
Registrar’s Office of your intent to graduate. Please complete step 1 below before you submit this form
to the Registrar’s Office.
Step 1: Submit the Graduate Student Application for Graduation Form online
Step 2: Complete the form below only after the online application has been submitted
Today’s Date: ______________
Student Information:
Student Name: ___________________________________________ Student ID #: _________________
(Please print)
Degree: _________________ Major: ___________________ When are you completing your degree requirements?
☐Spring ☐Summer ☐Fall
Year: 20___
For Ph.D. Candidates Only
Please List Previous Degrees: (list degree, college, city, state, country, date)
Please list all applicable courses being used for this degree.
Please include all courses already completed, those in progress and those proposed to complete the
program. Transfer course, including those taken at WPI under the BS/MS program, should be clearly
designated. Official transcripts being used for transfer credit (exception: WPI transcripts) must be
submitted with this application. Attach any petitions granting waivers to requirements.
Course Number Title Semester Credits Grade
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Page 1 of 2
Worcester Polytechnic Institute
Office of the Registrar
Please submit completed form to the Office of the Registrar, First Floor Daniels Hall.
508-831-5211 (tel) 508-831-5931 (fax)
100 Institute Road, Worcester MA 01609-2280
wpi.edu/+registrar
dr:1/24/18
Please list all applicable Independent Study, Directed Research, Thesis, or Dissertation Credits
Course Number Advisor Name Semester Credits Grade
_____________ ______________________________________ ______ ______ ______
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Total Credits: __________
Faculty Advisor for Ph.D. Dissertations only: The advisor(s) listed below will appear in the
Commencement program as your PhD advisor(s).
Required Examinations and Dates of Successful Completion:
This form must be approved by your department before it is submitted to the Registrar’s Office. The
Registrar’s Office will not accept this form without the proper approvals below. Your department may
require you to present your unofficial transcript from BannerWeb for approval of this form.
Student Signature: ________________________________________________ Date: _______________
Department Approval
Advisor Signature: ___________________________________________________ Date: ____________
Head of Department/Program Signature: ______________________________________ Date: ________
Registrar’s Office Use Only
Registrar Approval: ______________________________________________ Date: _________________
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Worcester Polytechnic Institute Graduate Degree Completion Form (Worcester Polytechnic Institute)

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Completed 2 September 2020

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