Central Michigan University
Undergraduate Application for Graduation
Name________________________________________________ Student ID____________
Last
Local Phone (_____)__________________
First
Cell Phone
E-mail Address_______________________________@cmich.edu
(_____)__________________
Home Phone (_____)__________________
(Students will be responsible for all correspondence sent via this e-mail account.)
SUBMIT THIS COMPLETED APPLICATION TO UNDERGRADUATE ACADEMIC SERVICES, CENTRAL MICHIGAN
UNIVERSITY, WARRINER HALL 123, MOUNT PLEASANT MI 48859 OR THE STUDENT SERVICE COURT, CENTRAL
MICHIGAN UNIVERSITY, ROOM 119, BOVEE UNIVERSITY CENTER, MOUNT PLEASANT MI 48859.
Applications are processed in the order they are received for each graduation.
Submission should be based on the timeline below.
Prior to:
 January 15 for August graduation
 April 15 for December graduation
 September 15 for May graduation
DIPLOMA NAME_____________________________________________________________________________________________
Print your name exactly as you would like it to appear on your diploma. Last name must correspond exactly to name of record in the Registrar’s Office.
DEGREE ____________________________________
1ST MAJOR __________________________________
CONCENTRATION _________________________
(If appropriate)
2nd MAJOR __________________________________
CONCENTRATION _________________________
(If appropriate)
3rd MAJOR___________________________________
CONCENTRATION _________________________
(If appropriate)
PROSPECTIVE GRADUATION DATE
(Check One Only)
AUGUST
YEAR________
(no commencement ceremony)
DECEMBER
YEAR ________
MAY
YEAR ________
TEACHING CERTIFICATE
(Check one if appropriate)
ELEMENTARY PROVISIONAL
1st MINOR____________________________________
SECONDARY PROVISIONAL
2ND MINOR ___________________________________
3rd MINOR____________________________________
IT IS YOUR RESPONSIBILITY TO REPORT ANY ADDITIONS,
DELETIONS, OR CHANGES TO ANY INFORMATION ON THIS
APPLICATION TO:
NEWSPAPER NOTIFICATION
CMU will notify your
local newspaper unless
you check box below.
NO
Undergraduate Academic Services
Central Michigan University
Warriner Hall 123
Mount Pleasant MI 48859
SECOND DEGREE
(Check if appropriate)
Phone: (989) 774-3504
______________________________________________________
Signature of Applicant
R-61 Rev. 11/10/09