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             Registrar's Office:

 

                     Completed: ___ Not Comp:___

                              GPA: ____________

                                Initials:             ____

                         Date: ________ / ________

 INTENT TO GRADUATE FORM

  • 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 multiple 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.   
  
*

I will complete all requirements in:

*

Check One

*

  Major in which you intend to graduate:

Name - Print EXACTLY as it should appear on the diploma

  
*

Student ID

*

First

Middle

*

Last

Suffix

 
  
*

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 your degree/certificate, please provide the information below:

School:

Course Number and Title:

Date course will end:

An official transcript from the institution must be sent to the Registrar's Office 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