APPLICATION FOR GRADUATION

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OFFICE OF ADMISSIONS AND RECORDS
PO Box 2216 Decatur, AL 35609
po
APPLICATION FOR GRADUATION
Priority Deadlines for Application to Graduate: Fall – November 1; Spring – April 1; Summer – July 1
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Complete one application for each degree for which you are applying.
Application MUST be submitted to the Admissions Office one term prior to graduation to ensure all requirements have been met.
Graduation Audit information will be sent to you via email.
There is no cost to have your degree posted on your academic transcript. However, to receive a copy of your diploma, a $20 fee
will be assessed to your student account.
If graduation requirements are NOT met within two terms, please notify the graduation analyst at [email protected] or
(256) 306-2607.
Please PRINT CLEARLY and return to the Admissions Office at the above address.
Student C # or SSN: _______________________________
Name:____________________________________________________________________________________________________________
Last
First
Middle
Address:__________________________________________________________________________________________________________
Street/Route/Box
City
State
Zip
Phone: ________________________________________ Email: _____________________________________________________________
EXACT name to appear on diploma: ___________________________________________________________________________________
Major / Academic Program: ________________________________________Concentration/Option if applicable: _____________________
I’m applying for: (check one)
Associate
in Science_______
Associate in
Applied Science________
Certificate________
Catalog Year: _____________________________________ Planned Term of Graduation:________________________________
If you are using a catalog other than the current catalog, you MUST have been continuously enrolled.
Are you a member of the following:
Phi Theta Kappa?
❏ Yes ❏ No
Sigma Kappa Delta?
Do you plan to participate in the Graduation Ceremony which is held annually in the month of May?
Do you wish to have a diploma mailed to the address above?
❏ Yes ❏ No
❏ Yes
❏ Yes ❏ No
❏ No
If yes, a $20 fee will be assessed to your student account.
_____________________________________________________________________________
STUDENT SIGNATURE
_________________________
DATE
ADMISSIONS OFFICE USE ONLY
Remaining Requirements:
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Program Code: ___________________________________________
Honors:
C
M
Met All Requirements:
S
WD
PTK
❏ Yes ❏ No
SKD
Final GPA: ___________________ Holds: _____________
Actual Graduation Date: ___________________________________________
REGISTRAR’S APPROVAL____________________________________________
Comments: ___________________________________________________________________________________________
Rev. 4/13
Revised 9/11/12
GRADUATING STUDENT SURVEY
Please indicate which one of the following was your PRIMARY educational goal when you began
classes at Calhoun: [MARK ONLY ONE]
To complete a certificate program
To obtain an Associate’s Degree
To transfer to a 4-yr institution
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To enhance job-related skills for current job
To obtain skills to change careers
To take courses for self-improvement
Did Calhoun Help you exceed your original educational goal?
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Yes
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No
Did Calhoun help you achieve your original educational goal?
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Yes
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No
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Considering your entire Calhoun experience, please respond to the following:
Calhoun provided quality instruction
Calhoun provided effective publications
(schedule, advertisements, etc.)
Calhoun provided opportunities for
extracurricular activities
I would recommend Calhoun to others
Calhoun provided me with a broad general
education
I would return to Calhoun for future education
What is your declared major?
Strongly Agree
Agree
Disagree
Strongly Disagree
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Estimated Graduation Date:
Which institution are you most likely to attend after you leave Calhoun? [MARK ONE]
 Alabama A & M
 Athens State
 Auburn
 AUM
 Montevallo
 UAB
 UAH
 UNA
 University of Alabama
 Jacksonville State
 Drake
 Wallace State/Hanceville
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 Other:____________________
Not Transferring
Which ONE of the following will you most likely use your Calhoun experience to pursue: [MARK ONE]
 Stay at my current job in my current position
 Open my own business
 Stay at my current job but advance my position
 I have no plans at this time
 Look for a new position
 Other:
Please mark ALL the following that applied to you while attending Calhoun:
 I entered Calhoun with a GED certificate
 I received Student Support Services
 I took developmental education courses
 I took dual enrollment with Calhoun
 I received financial aid
 I was an Upward Bound student
 I was the first person in my family to attend college
 I worked part-time or full-time
 I received ADA services
Please complete your student information:
Name:
Student ID#
Please fill in the following concerning your employment status:
Name of company where employed:
Company address:
Supervisor:
Occupation:
Full-time or
Part-time
Please check the statement below that best describes your current employment or education
status (check only one)
If you are employed:
Employed in an occupation related to my field of training AND pursuing additional education related to
my field of training
Employed in an occupation related to my field of training AND pursuing additional education not related
to my field of training
Employed in an occupation related to my field of training AND not pursuing additional education
Employed in an occupation not related to my field of training AND pursuing additional education
Employed in an occupation not related to my field of training AND pursuing education not related to my
field of training
Employed in an occupation not related to my field of training AND not pursuing education
If you are not employed:
Not employed AND pursuing education related to my field of training
Not employed AND pursuing education not related to my field of training
Not employed but actively seeking employment
Not employed AND not actively seeking employment
Or one of the following:
Entered a foreign military aid service of the Federal Government OR are serving on an official church mission
Entered military
Unavailable for employment due to illness or injury
Thank you for participating in the Calhoun Community College Graduation Survey!
Good luck in your continued endeavors!
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