Premier - GRADUATION PACKET

GRADUATION PACKET

Please allow thirty days (30) after completion of requirements to receive your certificate
Student Name:*

First NameMiddle NameLast NameSuffix
Email Address*
example@westcliff.edu
Student ID/Registration Number*
Note: Your name - {studentName} will appear on the diploma in the following order: first name, middle name or initial and last name, including suffix (if applicable) (exactly as it is listed above). This must conform to the official legal name of record at the time you graduate. Any name changes must be done by submitting proper documentation to the Registrar’s Office.
Certificate Title*
Course Name*
Please indicate the semester and year in which you completed all requirements to receive your certificate
Semester*
Year*
ex: 2021
Please indicate the semester and year in which you intend to complete all requirements for graduation.

{Semester} {year}
Will you attend Westcliff University's annual Commencement Ceremony?*

YesNo
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I understand that a certificate cannot be issued until all academic and financial obligations have been completed or otherwise cleared with the Registrar and Director of Finance
Applicant's Name:*
Please print your name legibly exactly the way you would like it to appear on the certificate. First letter of each name is capitalized and succeeding letters are in lowercase. Include hyphens, commas, suffix, spaces or any unique characteristics. WESTCLIFF UNIVERSITY IS NOT RESPONSIBLE FOR MISSPELLED NAMES.
Student Signature*
Date

MonthDayYear
Date
Should be Empty: