Graduation Application Form

Graduation application for graduation in Fall, 2012.

Student Information

* Last Name:

* First Name:

Middle Name or Initial:

* CWID#:

* Mines Email Address:

Hometown city, State and/or Country:

* Is the name entered above different from the one on your academic record? If you answer "Yes", you MUST submit a name change form (http://inside.mines.edu/Personal-Info) to the Registrar's Office before this change will be reflected on your diploma.
Yes
No

Degree Information -- If you are receiving multiple degrees on the same date you MUST complete a separate application for each degree.

* Has your Admission to Candidacy form been submitted to OGS for degree audit?
Yes
No

* Degree Title you expect to receive:

* Degree Level you expect to receive:

* Home Department or Department of Academic Advisor:

* Graduation Year:
2012

* Graduation Term:
Fall

* Will you be attending the Graduation Ceremony?
Yes
No

Graduation Ceremony Information. Complete this section ONLY if you WILL BE ATTENDING the Graduation Ceremony

Your height in feet and inches:

Doctoral (PhD) recipients please list your previous degrees and the University/College from which you received them:

Doctoral (PhD) recipients please list the name of your advisor and/or co-advisor:

Post-Graduation Contact Information. Please note that the production of the silver diplomas requires about three months. A permanent mailing address and email contact are needed so that shipping issues may be resolved quickly and, for those attending Commencement so that the official photographer may email you photo proofs for review.

* Post graduation, permanent Email address:

Phone number:

* Shipping Street Address:

* Shipping City:

Shipping State:

* Shipping Country:

* Shipping Zip or Country Code:

* required