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                  INTENT TO GRADUATE FORM

  

Registrar's Office:

Completed: _____

Not Comp:  _____

GPA: ____  Initials:_____

Date: ____/_____

 

  • This form is necessary so that the Registrar's Office can review your academic history and verify that all curriculum requirements have been met, to certify your eligibility for gradation and to order your diploma.
  • If you are a candidate for two degrees/certificates please complete a separate form for each degree or certificate.
  • A minimum cumulative quality point average of 2.00 is required for graduation.
  • All fields with * must be completed.   

 

  

Degree Information

  
*

I will complete all requirements in:

*

  Major in which you intend to graduate:

*

Check One

Personal Information

  
*

Student ID  

 

Name - Print EXACTLY as it should appear on the Diploma:

  
*

First

Middle

*

Last

Suffix

 
  

Your diploma will be mailed to the address below unless you update your mailing address:

  
*

Street Address

*

City

*

State

*

Zip

*

E-mail

Home Phone or Cell:

 

If you are currently taking or will be taking transfer course(s) elsewhere to complete a degree or certificate at Quinsigamond Community College, please indicate here:

School:

Course Number and Title:

Date course will end:

An official Transcript from the institution must be sent to the Registrar at Quinsigamond Community College upon completion of the course.

  

I understand that the Registrar's Office will inform me via email to my QCC Qmail account regarding graduation eligibility and other information.

*

Type in your First and Last name as an electronic signature

*

Date