Caldwell Community College & Technical College
2855 Hickory Blvd Hudson, NC 28638 372 Community College Drive Boone, NC 28607
Application for Degree/Diploma/Certificate
Meet with your advisor when completing this application.
Complete one application per degree/diploma/certificate.
($25 for the first application plus $15 for each additional degree/diploma/certificate per academic year)
Return Completed Form and Graduation Fee to the Business Office.
Application due semester before anticipated completion date.
(Graduation fee non-refundable)
Student ID Number: ______________________ Date: _____________________
Print name:_________________________________________________________________
First Middle Last
(Do Not Use Initials)
Address: ____________________________ ______________ _______ ____________
Street City State Zip
If name or address differs from current information on file, you must complete a Permanent Record Change Form.
Phone: _______________________ _______________________ _______________________
Home Work Mobile/Cellular
Expected graduation term/year ☐ Fall ☐ Spring ☐ Summer Year: _______________
Program: ________________________________________ Program Code: ________________
Check appropriate box below:
Will you be present for the graduation ceremony? Yes No
Gown information if participating: Height_________
COLLEGE PERSONEL USE ONLY
Catalog student is graduating under: _____________________________
(to be confirmed by the advisor)
Advisor Signature: Date:
Amount Paid $ _________ Charge # _________ Cashier __________ Date _________
