COLLIN COLLEGE - ADMISSIONS & RECORDS OFFICE PETITION ...

COLLIN COLLEGE - ADMISSIONS & RECORDS OFFICE PETITION FOR GRADUATION (Print name exactly as you want it to appear on your diploma. Last name must match what is on your records at Collin.) NAME___________________________________________________________________________ CWID or DATE OF BIRTH _________________________ LAST FIRST MIDDLE NAME MAILING ADDRESS _________________________________________________________________________ PHONE _____________________ _________________ STREET APT. # CITY STATE ZIP HOME WORK

AA-GENA or Field of Study _____________________ AS-GENS or Field of Study _________________________ AAT-Major ____________________________________ AAS-Major________________________________________________________ Certificate-Major________________________________________________

Are you currently taking courses at another school to transfer back for graduation? ________ EXPECTED COMPLETION DATE______________________________________ INCLUDE NAME IN COMMENCEMENT PROGRAM AND PRESS RELEASE

PARTICIPATE IN GRADUATION, IF ELIGIBLE

______ YES _____ NO

__________ YES _________ NO

STUDENT SIGNATURE____________________________________________________________________________ DATE ___________________________  OFFICE USE ONLY: ______TSI REQUIREMENTS SATISFIED ______18 HOUR RESIDENCY SATISFIED ______DIRECTORY INFORMATION RELEASE

______2.0 GPA SATISFIED ______HONORS ______PTK/PB/NT

______CORE COMPLETE ______ALL HOLDS CLEARED _____INSTITUTIONAL COURSES CHECKED

COURSES NEEDED:_______________________________________________________________________________________________________________ AUDIT/LETTER MAILED: ___________________________________________________________________________________________________________ __________ ALL REQUIREMENTS SATISFIED __________ REQUIREMENTS NOT COMPLETED

__________ FILE INACTIVATED __________________

EVALUATED BY:______________________________________________________________DATE:_______________________________________________

Collin County Community College District does not discriminate on the basis of race, color, religion, sex, national origin, age, disability or veteran status. With few exceptions, state law gives you the following rights regarding the information collected by Collin about you: The right to request to be informed about the information, the right to receive and review the information and the right to correct information about you that is incorrect. 3725-07-EOT + 5 Revised 6/2010