University of Northern Iowa

University of Northern Iowa
GRADUATION APPLICATION - BACHELOR'S DEGREE
Students graduating at the end of the semester must complete this form and return it to the Office of the Registrar

Student No. ______________________	Degree Completion Date _________________________ Month Year
Today's Date _____________________	Graduation Ceremony Attending ___________________ Month Year
NAME (to be printed on diploma & in commencement program): _____________________________________

HOME TOWN (to be listed in comencement program): ___________________________________________

(Graduation information will be sent to your local address)

LOCAL ADDRESS ________________________________________ Street City State Zip	Ph (_____)_____________
HOME ADDRESS _________________________________________ Street City State Zip	Ph (_____)_____________

NON-TEACHING	TEACHING
____________________________________ Major(s)	____________________________________ Major(s)
____________________________________ Minor(s)	____________________________________ Minor(s)
	Areas of certification other than major and/or minor: ______________________________________

DO NOT WRITE BELOW THIS LINE - FOR OFFICE USE ONLY

SR# _____________________________

MIN HRS ________________________

HRS REC ________________________

NEEDS:

100 MAJ _________________________

WCX ____________________________

LAB _____________________________

FRN LNG ________________________

UNI GPA _________________________

CUM GPA ________________________

MAJ GPA _________________________

DEFICIENCIES:

This information is requested for the purpose of initiating your graduation process.All items are directory
infomation and therefore may be released to third parties. All items are required and thereforeincomplete forms
cannot be processed. (Pursuant to Chapter 22, Code of Iowa)