Completion Review for the Graduate Certificate in Educational Technology
Michigan State University College of Education
PID: A
Name:
Program Code / Name:
6736 / Educational Technology Graduate Certificate
For Graduate Certificate Requirements, please see http://reg.msu.edu/AcademicPrograms/ProgramDetail.asp?Program=6736
Proof of Course Completion: In the table below, please indicate that you have completed all 3 required courses and indicate the semester in which
you successfully passed each course. To this form, attach a printout from Stuinfo that shows completion of the required courses with grades of 2.0 or
higher. Conferral of this credential requires a cumulative GPA of 3.0 in the three required courses. Upon verification that all requirements have been met,
the program code will be marked as conferred on your student record. This form must be filed for this certificate to be listed on your transcript.
i
Graduate Certificate in Educational Technology
Completed
Semester course
was taken
CEP810 (required) – Teaching for Understanding with Technology
CEP811 (required) – Adapting Innovative Technologies to Education
CEP812 (required) – Applying Educational Technology to Issues of Practice
Additional information/notes:
Student: I attest that the information provided on this form is accurate. (All signatures must be in blue ink.)
Student Signature
Date
Program Advisor: I have reviewed the student's program plan and, based on this review, affirm that this student is eligible for conferral of the Graduate
Certificate in Educational Technology.
Program Advisor Signature
Date
Please forward this form to the Educational Technology Secretary, Heather Johnson, at Erickson Hall, 620 Farm Lane Room 513, East
Lansing, MI 48824, who will acquire the remaining signatures.
Program Secretary Signature
Date
Program Secretary signature on this form certifies that the student has met all of the requirements for the Graduate Certificate.
Program Coordinator
Date
Department Chairperson
Date
Please submit this form to the Graduate Records Office, 620 Farm Lane, Room 204, Erickson Hall, who will secure the Associate Dean’s
signature.
Associate Dean, College of Education
Date
Registrar’s Office: When all signatures appear, we certify that this student has successfully completed all of the requirements to confer the Educational
Technology Graduate Certificate (code 6736).
GRO Notes: GRO sends final document to RO.
5.2015-MSH