Please submit this form with the appropriate fee ($90 for Masters, Specialists & Doctoral Degrees; $90 for Graduate Certificates) to: The Cashier’s Office, 201 Pierce Hall, Eastern Michigan University, Ypsilanti, Michigan 48197.

This form must be submitted by the posted deadline for the indicated semester. Failure to submit an application by the deadline may result in a one semester delay in your degree or certificate being awarded.

APPLICATION FOR GRADUATION IN: APRIL _____JUNE _____ AUGUST _____ DEC _____ YEAR_____

Student Number _________________________ Social Security Number _____________________________

TYPE OR PRINT YOUR NAME EXACTLY AS IT SHOULD APPEAR ON YOUR DIPLOMA OR CERTIFICATE:

___________________________________________________________________________________________________
           (FIRST NAME)                                        (MIDDLE NAME)                              (LAST NAME)

Current local mailing address: ________________________________________________________________________
                                                                     street                               city                           state               zip

Home phone number: (________)__________________ Work phone number: (________)______________________

PLEASE INDICATE A DIPLOMA MAILING ADDRESS BELOW. THIS IS WHERE WE WILL SEND YOUR DEGREE POSTED TRANSCRIPT AND DIPLOMA.

Diploma mailing address: ____________________________________________________________________________
                                                                     street                                      city                               state               zip

Degree applying for: (circle one) Graduate Certificate MA MFA MS MSW MSN MBA MBE MLS MOT MPA SpA EdD PhD

Program: ____________________________ Concentration: _______________________________________

IF YOU ARE USING TRANSFER CREDIT, PLEASE READ AND NOTE: If transfer credit is to be used on the degree, the following criteria must be met: An official transcript must be on file in the Graduate Studies Office no later than one month prior to the degree award date; the course must have received a grade of “B” or better and must be indicated as graduate credit; the course must not be over six years old at the time you complete your degree; and the course must appear on a program of study. Failure to comply with these guidelines will result in a delay in your degree being awarded. Contact your advisor about the use of transfer credit.

Please indicate below the name of any institution(s) from which you are using transfer credit:

__________________________________________________________________________________________________________

Date of application: ____________________ Signature: _____________________________________________________

DATE TRACKED: ________________________DATE ADMITTED: ______________________
DEGREE TO BE AWARDED: MASTER OF ______________________________________________________________
                                                   SPECIALIST IN ________________________________________________________________
                                                   DOCTORATE IN _______________________________________________________________
                                                   CERTIFICATE IN ______________________________________________________________