Certificate Of Eligibility For A Graduate Degree

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CERTIFICATE OF ELIGIBILITY FOR A GRADUATE DEGREE
Name:
Student#:
Last
First
Middle
Address:
Street
City
State
Zip
Phone:
Home
Work
Extn
Other
Email:
Degree:
Major:
MA
MAT
MBA
MS
MSE
EDS
Fall
Summer
Spring
Graduation Term Enrollment:
Year:
Course Title
Hours
Dept
Course #
Yes
No
Are you seeking initial or additional certification with this degree?
If, yes be sure you submit
an application for certification to the Director of Clinical Services and Certification, Lovinger 2170, or see your advisor.
I certify that the above information is correct. The University is given approval to publish the thesis abstract.
Date:
Student's Signature:
TO BE COMPLETED BY THE ADVISOR:
Student's transcript indicates the student's graduate grade record to date on all graduate work attempted is as follows:
Semester Hours:
A
B
C
D
F
U
(List Below) Transfer Hrs:
Courses with a "U" grade:
Course #
Course Title
Hours
Sem
Year
Dept
Required/Date Completed Required/Not Completed
Not Required
Thesis/Bindery#
Research Paper(s)#
Comprehensive Exam
I certify that the above information is correct, that I have examined an up-to-date transcript of this student, check the
approved program, and verify that, if the student completes satisfactorily the courses taken as listed above, the student is
eligible and is recommended for the degree in the program named above.
Signature of Advisor
Date Approved by Advisor
Signature of Graduate Coordinator/Department Chair (if applicable)
Date Approved by Department
Signature of College Representative (if applicable)
Date Approved by College
Form Color: Blue
Revised Jun 2004

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