Application For Award Of Graduate Degree Form

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Application for Award of Graduate Degree
Instructions
Do not hand write - Must be typed
This form is to be used by students who have an approved candidacy form on file at the GAPE office. This completed form should be emailed to the appropriate GAPE evaluator
(see ), submitted to Window G in the Student Services Center, or sent through interoffice mail to extended zip 0017.
Student Information
First Name, M.I.
Last Name
Previous Name (if any)
Student ID
Address to Send Diploma
City
State
Zip
Daytime Phone
Email Address
Please update your mailing and email addresses on MySJSU under Personal Information. A change of address can also be filed with the Office of the Registrar
via the Address/Contact Update Request at
Degree Type
MA
MS
MSW
MLIS
EdD
MPH
DNP
MBA
MPA
MUP
Other (specify)
Planned Graduation Date (Semester/Year)
Major (Concentration, if applicable)
Name on Diploma
Full name as it will appear on your diploma. The last name must be the same as in your SJSU record, or you will need to file for a name change with the office of the
Registrar via the Change of Name form at
Last Name
First Name
Middle Name(s) or Initial(s)
Degrees Now Held
City
Degree
Month/Year
Institution Granting
State
Country
Required Signatures
Student
Signature
Date
FOR OFFICE USE ONLY - DO NOT WRITE BELOW THIS LINE
To Do
Thesis/Dissertation
Binding
Transfer Graduate Credit
Culminating Memo
Final GPA
Total Graduate Units
GAPE Evaluator
Approved
Denied
Name
Date
Application for Award of Graduate Degree
Version 11-2015

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