Graduation

Application for Graduation

August Graduation (December Commencement Ceremony)

PART I

*Student ID:
 

*Name: 

[Please FILL IN EXACTLY as you wish it to appear on diploma.]

NOTE: Please contact Registrar's Office if your name contains multicultural accents.

*Name Phonetic Pronunciation:


Sample Name: Beethoven      Pronunciation: Bay-toe-ven

Current Address [Where we can contact you PRIOR TO Graduation.]

*Address:


*City:


*State:


*Zip Code:


Home Address [Where we can contact you AFTER Graduation.]
Copy from Current Address:

*Address:


*City:


*State:


*Zip Code:



Phone(s):

*Daytime Phone:


*Cell Phone:



*Lewis Email Address (all correspondence will be sent to this email):


*Please re-enter Lewis Email Address:



Other Email Address:


Please re-enter Other Email Address:



*College:
Arts and Sciences
Education
Business
Nursing and Health Professions

*Degree:
2-yr Aviation (06)
Associate (08)
Bachelor's
Master's
Certificate of Advanced Study
Doctorate

Major:
1)
    Concentration/Track (if applicable):
    

2)

Minor:
1)
2)


Please Note:
If for any reason you find that you will not graduate on the date designated above, please contact the Registrar's Office and withdraw your application. You must re-apply for a future date. Your application is not carried over automatically to the next graduation date.



PART II

TRADITIONAL UNDERGRADUATE

Directions: Your responses to the following questions will provide us with important feedback about your experience at Lewis

*Please check the box that best describes your plans for after graduation. 
 I plan on working
 I plan on attending graduate school
 I plan on working and also attending graduate school
 I am still deciding what i would like to do after graduation
 I do not know what I want to do after graduation
 Other (Please Describe)

     

If you know where you will be working or enrolled in graduate school please indicate below.

Employer:

Title:

Location:


and/or:

Graduate School:

Program:

Degree:

Location:


*How closely will your career or graduate school plans be related to your major field?
 Very closely related
 In the same general area
 Slightly related
 Not at all related
 I don't know

*Please indicate your level of agreement with the following statement: My academic degree program at Lewis has prepared me with the knowledge, skills, and abilities to enter or advance a career, or to begin graduate study.
 Strongly Agree
 Agree
 Somewhat agree
 Disagree
 Strongly disagree


Please check all activities that you participated in while a student at Lewis.
Internship
Study Abroad
Community Service
Research project
Student_Organizations
Career preparation workshops and counseling
Campus Ministry
Leadership opportunities
Other: 

*Would you be interested in providing a short testimonial on your experiences at Lewis that could be shared with future students?
 Yes
 No

Any other comments you would like to share?




*Signature:


Date:3/31/2015