Application For A Graduate/doctoral Degree Form

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Application for a Graduate/Doctoral Degree

Please TYPE ALL information, which cannot be saved or submitted electronically. Handwritten forms will be returned for resubmission. Print the

completed form to submit to your program for signatures. Print an extra copy for your records. Incomplete/incorrect forms will not be processed.

Anticipated semester meeting degree requirements:  Fall

 Spring

 Summer

Year:_______________

Walking at commencement?  Yes  No

Fall ____ Spring ____ Year:______________

Full Legal Name: ____________________________________________________ JMU Email Address: ___________________________________

Student ID: _____________________________________ Telephone: ____________________________________________________

After graduation, your diploma will be sent to the permanent address listed in MyMadison while information regarding the commencement ceremony

will be mailed to your local address. _____ I have corrected my permanent and local addresses in MyMadison.

Program of Study: ___________________________________ Concentration(s): ____________________ ________________________

Degree:  Au.D.

 D.M.A.  D.N.P.

 Ph.D.  Psy.D.

 Ed.S.

 M.A.

 M.A./Ed.S.

 M.A.T.

 M.B.A.

 M.Ed.

 M.F.A.

 M.M.

 M.O.T.

 M.P.A.  M.P.A.S.

 M.S.

 M.S.Ed.

 M.S.N.

 Fall

 Spring  Summer

Date Academic Program Began:

Year: ___________

List your Program of Study course information below. Attach a separate sheet if necessary. Do not attach a transcript. PLEASE NOTE: You

must be registered for at least a one-credit course in your program of study the semester in which you graduate.

Semester

Credit

Semester

Credit

Hours

Course #

Title

Taken

Course #

Title

Taken

Hours

Grade

Thesis/Dissertation/Ed.S. project chair (if applicable): ___________________________________________________________________

Dissertation title (if applicable): ____________________________________________________________________________________

Student Signature: _______________________________________________________ Date: ____________________________________

This section to be completed by appropriate department:

I have checked the record of this applicant for graduation against the required courses. The applicant will fulfill requirements in their program upon (1)

successfully completing all of the courses listed above and (2) achieving a cumulative grade point average of 3.0 or better.

_________________________________________________________

________________________________________________ ______________

Advisor (Print Name)

Advisor (Signature)

Date

___________________________________________ ____________

Program Director (Signature)

Date

___________________________________________ _____________

________________________________________________ ______________

Academic Unit Head (Signature)