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

ADULT/GRADUATE/CERTIFICATE of ADVANCED STUDY/DOCTORAL

Directions: Please check the box that best describes your plans after graduation. Your responses will provide us with important information about your experience at Lewis.


I will continue in my current position within my current organization
Employer:

Location:

Position/Title:



I will have/will be seeking a new position within my current organization
Employer:

Location:

New Position/Title:



I have obtained a new career opportunity
Employer:

Location:

Position/Title:



I plan to pursue additional degrees or certification
Program:

Degree:

College/University:



I am unsure of my plans at this time

Other (Please describe):
     

*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

What aspect of your education at Lewis had the most impact on your career?




*Signature:


Date:3/4/2015