Application for Certificate or Short Certificate

APPLICATION FOR CERTIFICATE OR SHORT CERTIFICATE

Please remember to check your student email for information about graduation. All fields marked with * are required.

Candidate Name*

First Name

Last Name

Student Identification Number*

Diploma Name

Type below the name as you wish to appear on your diploma. (Please note: If you need to make a legal name change on your student records, you will need to submit a Change of Records Form. You will be required to provide requested documentation to validate the changes.)

Diploma Name*

Contact Information

Type the information below. (Please note: This will not update your address information in MyLawson. You will need to log into MyLawson to make the necessary changes.)

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Student Email:*

Personal Email:*

Primary Contact Number:*

Certificate or Short Certificate Information

Completion Term:*

Please select the certificate type:*

Long Certificate Short Certificate

Program of Study*

Have you applied for graduation before?*

Yes No

Do you plan to participate in the Commencement Ceremony? *

Yes No

IMPORTANT REMINDERS:

1. Before completing this form, students should consult with their Academic Advisor and check their Degree Audit to make sure all requirements have been satisfied in their program of study.

2. The graduation fee of $75 is a requirement for all graduates. However, if you enrolled in the ORI101 or ORI101T (Orientation to College) at Lawson State Community College after August 2013 (Fall13-14 term), the cost of graduation may have been satisfied. You may emailed The Office of Business Affairs at businessoffice@lawsonstate.edu to verify. THIS FEE IS NONREFUNDABLE AND SUBJECT TO CHANGE WITHOUT PRIOR NOTICE.

3. All financial obligations and student account hold(s) must be cleared prior to receiving your diploma and official transcript. You may emailed The Office of Business Affairs at businessoffice@lawsonstate.edu to verify.

4. If you do not qualify for your certificate or short certificate the semester in which you originally apply, you must submit a new application for graduation in the semester in which you will meet the requirements for your award.

MORE INFORMATION:

If you have questions, contact the Office of Student Records at 205.929.3413 or send an email to records@lawsonstate.edu.