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FOR TERM/YEAR
Declaration of Intent
to Receive a Degree/Certificate
Registrar’s Office
160 East Tenth Street, Claremont, CA 91711 • Ph. (909) 621-8285 • Fax (909) 607-7285 • student.records@cgu.edu
Student Information: Print your name as it is recorded on your official CGU student record. If you need to file an official name change, please submit a
Change of Name or Address Form to the Registrar’s Office.
Last Name
First Name
_______
CGU ID #254 -
Middle Name ________________
_______________________________ E-Mail ______________________________________________@ cgu.edu
Date of Birth (MM/DD/YYYY) ________________________________________ Phone (__________)_______________________________________
You must declare your intent to receive a degree/certificate by the deadline for the semester in which you expect to graduate.
This deadline is announced in the Academic Calendar. Forms must be submitted to the Registrar’s Office by this date.
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Upon receipt of this form, you are placed on a preliminary degree list and a preliminary degree-posting transaction appears on your transcript.
You must complete your degree requirements by the deadline announced in the Academic Calendar. If you do not complete your degree requirements, you are
removed from the degree list. To graduate in a subsequent semester, you must submit a new Intent form for the next semester you expect to graduate.
Commencement information is distributed during the Spring semester to all candidates who expect to graduate in the Spring semester as well as to all degree
recipients from the previous Summer and Fall semesters.
For Doctoral Students
♦
♦
International The day you submit your dissertation is considered the last day of your academic program as it relates to your SEVIS program end date.
Domestic Your last date of enrollment as it relates to loan repayment is equal to the last date of the last semester in which you enrolled, regardless of
the date you submit your dissertation.
For Master’s Students
Degrees are posted when all final grades have been submitted by your instructors. Students continuing into a new CGU program should not be impacted.
Enter your expected graduation term in the TERM/YEAR box at the top of this form and check all of the following that apply.
I am a certificate only student.
I am an interfield student.
I am certificate student who is also completing a degree.
This is my final degree and I will be departing from CGU.
I am receiving this master’s degree along the way to my PhD.*
I plan to begin a subsequent degree at CGU and have filed a
I am a dual degree student.*
Changing to a New Degree form.*
* Note: Please refer to the CGU Bulletin for policies on degrees and sharing units. Units may only be shared by a maximum of two degrees.
I intend to complete the following degree/certificate this semester: (Submit separate forms for each degree/certificate.)
Academic Department ______________________________________________________________________________________________________
(Management, Cultural Studies, Psychology, Religion, Teacher Education, etc…)
Degree or Certificate ________________________________________________________________________________________________________
(ex: Ph.D. in Religion / Ph.D. in Psychology / MS in Mathematics / MA in International Studies / etc…)
Student Signature _____________________________________________________________ Date _______________________________
COMMENCEMENT CEREMONY
For student receiving degrees in Summer and Fall, would you like to participate in
the subsequent Spring’s Commencement Ceremony?
Yes
No
We will mail a packet of information about the ceremony to you prior to the event.
MAILING ADDRESS FOR YOUR DIPLOMA
Indicate the address where you would like your diploma sent.
Check here to update your student record with this mailing address,
If your address changes again after the end of this semester, please notify us.
Additionally, please provide phonetic guidelines for pronouncing your name.
First Name:
Middle Name:
Last Name:
For Office Use
Received:
Posted:
Notes:
CF 510 Rev 2/10
Student Exit/Degree Completion Survey
The following survey includes questions concerning your experience at CGU, your academic training, student
services, campus climate and your plans after receiving your degree. This information is used to assess and
improve the graduate programs and student services. Please fill in circles completely.
All responses will remain confidential and used in aggregate only.
A.
Satisfaction with CGU/departments/services
Please indicate your level of agreement or disagreement with each of the following statements.
Strongly
Disagree
1.
I am pleased that I chose to do my graduate study at CGU.
2.
The courses I took were valuable for my intended profession.
3.
The quality of academic advising was high.
4.
The quality of supervision by my dissertation chair was high.
5.
Faculty were supportive of my academic interests.
6.
I had the opportunity to develop a mentoring relationship with a faculty member.
7.
I received useful feedback from faculty on my class performance.
8.
Students in my department were treated with respect.
9.
I was encouraged to participate in professional development opportunities by my department.
10.
I had the opportunity to develop teaching skills.
11.
I had the opportunity to develop research skills.
12.
I had the opportunity to develop grant/proposal writing skills.
13.
Training in academic issues related to diversity has influenced my scholarship.
14.
The courses in my department included topics related to diversity (cultural, ethnic, or gender).
15.
I feel well prepared by CGU for the next phase of my career.
16.
Overall, I am satisfied with my department.
17.
I would recommend CGU to someone who was thinking about graduate study.
Disagree
Neutral
Strongly
Agree
Agree
NA
Please indicate your level of satisfaction or dissatisfaction with the following services at CGU.
Very
Dissatisfied
Dissatisfied
18.
Admissions Office
19.
Career Management Center
20.
Computer Support/Help Desk
21.
Financial Aid Office
22.
Minority Mentor Program
23.
Preparing Future Faculty Program
24.
Registrar’s Office
25.
Writing Center
B.
Academics, while at CGU
26.
How many academic conferences did you attend?
27.
How many papers have you PRESENTED at professional conferences?
28.
How many papers have you SUBMITTED for publication?
29.
Of those papers, how many were accepted for PUBLICATION?
Neutral
Satisfied
Very
Satisfied
Did Not
Use
Zero
1
2
3
4
5 or more
Yes
No
30.
Is your thesis or dissertation transdisciplinary?
31.
What was THE major challenge to
completing your thesis/dissertation?
32.
What was THE major challenge to
completing your coursework?
C.
Future plans and past employment
33.
Do you have DEFINITE plans for continued study or employment after graduation?
34.
What are your plans for continued study?
35.
What are your plans for employment?
a.
b.
Yes
PhD
Prof.
Degree/Cert
Post Doc.
Education
Other
No Plans
Tenure
Track
Non-Tenure
Track
Instructor/
Adjunct
Admin.
Appt.
No Plans
Private
Sector
Public Sector
NonProfit
No Plans
Academic Employment
Other Employment
Yes
36.
No (go to question 38)
During the past twelve months, were you employed?
Less
than 11
37.
No (go to question 36)
11 to 20
21 to 30
31 to 40
More
than 40
How many hours a week did you typically work?
D. Harassment and Discrimination
HARASSMENT is uninvited and unwelcome verbal or physical conduct, comment or display that demeans, belittles, intimidates or
humiliates another person or group.
Have you personally experienced or witnessed harassment (as defined above) at Claremont Graduate University in the current
academic year? If you have, please indicate which type(s), otherwise select “did not experience or witness.”
38.
Type of harassment personally experienced. (Mark all that apply)
Did not
experience
39.
Age
Disability
National Origin
Race/ethnicity
Religion
Gender
Sexual
Orientation
Other
National Origin
Race/ethnicity
Religion
Gender
Sexual
Orientation
Other
Type of harassment witnessed. (Mark all that apply)
Did not witness
Age
Disabiity
DISCRIMINATION is the unfair and unequal treatment or consideration of a person or group on the basis of class, category, partiality
or prejudice.
Have you personally experienced or witnessed discrimination (as defined above) at Claremont Graduate University in the current
academic year? If you have, please indicate which type(s), otherwise select “did not experience or witness.”
40.
Type of discrimination personally experienced. (Mark all that apply)
Did not
experience
41.
Age
Disability
National Origin
Race/ethnicity
Religion
Gender
Sexual
Orientation
Other
National Origin
Race/ethnicity
Religion
Gender
Sexual
Orientation
Other
Type of discrimination witnessed. (Mark all that apply)
Did not witness
Age
Disability
E.
Finances
42.
Which type of funding did you receive during your studies? (Mark all that apply)
Loans
CGU
Scholarship/
Fellowship
Outside
Scholarship/
Fellowship
Research
Assistantship
Grants
Administrative
Assistantship
Teaching
Assistantship
Corporate
Sponsorship
Tuition
Remission
Other
Other (specify)
For questions 43 and 44, please write each digit of the number on each line. If not using the interactive form, please also circle the
corresponding number beneath each digit.
43.
44.
BEFORE you first enrolled at CGU, what was total amount of
educational loans you acquired (in thousands or dollars)?
,000.00
$
$
0
0
0
0
0
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
6
6
6
6
6
6
7
7
7
7
7
7
8
8
8
8
8
8
9
9
9
9
9
9
Demographics
45.
Which of the following best describes your student status while:
Full Time
a.
Taking classes?
b.
Writing your dissertation or thesis?
1
2
3
Part Time
4
FT and PT
Not Applicable
5 or more
How many years were you in the program
you are applying to receive a degree in?
Master’s
47.
,000.00
0
F.
46.
WHILE enrolled at CGU, how much NEW educational debt have you
acquired (in thousands of dollars, excluding prior loans)?
Which degree are you currently applying to receive?
Doctorate
Dual
Certificate
Credential
48.
49.
50.
Which program is the degree you are currently applying to receive in? (mark all that apply)
Applied Women’s Studies
Financial Engineering
Politics and Policy
Art
Health Information Management
Politics, Economics, and Business
Arts Management
History
Psychology
Botany
Human Resources Design
Psychology
Cultural Studies
Information Systems and Technology
Public Health
Economics
Management
Public Policy and Evaluation
Education
Mathematics
Religion
English
Music
Teacher Education
Executive Management
Philosophy
Other
Female
Male
US Citizen
Perm. Res.
What is your gender?
International
If International, from which country? (go to question 52)
What is your residency status?
American Indian/
Alaskan Native
African
American
Asian
Pacific Islander/
Hawaiian
Latino/Latina
White
Multi-racial
Other
51.
What is your racial background?
52.
Strictly for survey tracking purposes, please provide the six middle digits of your student ID number. ID’s will be stripped from the data once the data has been compiled
to ensure anonymity. If not using the interactive form, please also circle the corresponding number beneath each digit.
254 -
-0
0
53.
0
0
0
0
0
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
6
6
6
6
6
6
7
7
7
7
7
7
8
8
8
8
8
8
9
9
9
9
9
9
Please share any suggestions or comments you might have. Use additional paper if necessary.
Thank you for completing this survey. All responses will remain confidential and used in the aggregate only.
Drucker-Ito students- Please continue on to next page
Drucker/Ito Graduates Only
The following questions are important for the Drucker/Ito School and for Career Services. Only Drucker/Ito
graduates are requested to complete this page.
All information will remain confidential and be used in the aggregate only.
D1.
ANSWER THE FOLLOWING ONLY IF YOU HAVE ACCEPTED A JOB OFFER.
What was your undergraduate major?
Business
D2.
Technical
D14.
Other (specify)
Company Name
What company did you accept a job offer from?
Country (if outside of USA)
How much professional experience do you have?
1 year or less
D15.
More than 1 year, but less than 3 years
More than 3 years, but less than 5 years
More than 5 years
D3.
Do you plan on starting your own business
within the next 10 years?
D4.
D5.
Did you do an internship while in your program?
Yes
No
NA
Yes
No
NA
D16.
Did you want to do an internship while in your
program?
D6.
Did you get any assistance from CGU to find an
internship?
D7.
What is your employment status?
D17.
I am company-sponsored or already employed
What is your primary function?
Marketing/Sales
Operations/Logistics
Finance/Accounting
General Management
Consulting
Human Resources
MIS
Other (specify)
What is your primary industry?
Manufacturing
Financial Services
Government
Consulting Services
Not-for-Profit
Other (specify)
If you had an internship, is your full-time job with your intern company?
Yes, and my internship was school facilitated
I am starting a new business as owner
Yes, and my internship was student facilitated
I have been seeking employment (go to question D13)
No
I have postponed my job search (stop here)
D18.
Other (specify)
What is the primary source of the job you accepted?
School facilitated source
While in the program did you:
Yes
D8. Transition to another role in your organization?
D9. Find a new job?
D10. Get a promotion?
No
Student facilitated source
NA
Salary information in US Dollars
Benefits or perquisites such as cars, equipment, memberships, stock options, and
moving services are not equated and are not included in any compensation category.
D11.
What was your annual base salary before you
started your program?
US$
D12.
What is your annual base salary now leaving
the program?
US$
D19.
Annual base salary for your job:
Excludes bonuses, commissions, and any other
compensation
US$
D20.
Signing bonus:
US$
D21.
Other compensation:
Other taxable payroll compensation such as
guaranteed annual bonus and guaranteed
overtime.
US$
IF YOU DID NOT SEEK EMPLOYMENT, STOP HERE.
D13.
What is your job seeking status?
Offer received but declined or do not plan to accept
Holding an offer(s), but have not made a decision
Have accepted an offer
Have not received an offer and I am still seeking
Other (specify)
Thank you.
Your responses will remain confidential
and only reported in the aggregate.