Campbell University Application for Graduation
School of Education Graduate Programs
Phone: __________________________
Campbell ID: _________________
Email: __________________________________________________
I hereby request that an order be placed for a Diploma for the Degree of:
Master of Arts
Master of Education
Master of School Administration
With a Major in: ________________________________________________________________________________
To be awarded to me in (please circle one): August
December
I wish to have my name printed EXACTLY this way on the Diploma:
May
Year: _______________________
(Please Print carefully)
The following information will be printed in the graduation program:
Hometown Address:
(City)
Undergraduate Information:
(State)
University of undergraduate degree:______________________________________________ Year:_____________
City, State:_____________________________________ Type of Undergraduate Degree:___________(ex B.S., B.A.)
Current address for mailing information concerning audit or graduation rehearsal or other pertinent information in
connection with my graduation:
(Route, Street, or Post Office Box No.)
Address for mailing my Diploma in case I do not carry it with me on the date of my graduation:
_____________________________________________________________________________________________
(Route, Street, or Post Office Box No.)
Attendance:
I do plan to attend graduation
I DO NOT plan to attend graduation
Signature:_____________________________________________________________Date:____________________