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SOMERSET COMMUNITY COLLEGE GRADUATION APPLICATION (Somerset Community College)
On average this form takes 9 minutes to complete
Country of origin: US
File type: PDF
U.S.A. forms for Somerset Community College
(Last day to apply – April 3, 2020 ) (Last day to apply – September 14 , 2020 ) (Last day to apply – February 5, 2021)
Thank you for applying for your credential (degree/diploma/certificate) from Somerset Community College. You are considered a
candidate for the credential until the audit process has been successfull y completed. This does not necessarily indicate that your
cr edential will be awarded ; it simply indicates that you have applied for a c redential to be awarded by Somerset Community College.
Directions: ( A ) Please complete, sign and date this application. ( B ) Obtain your advisor’s signature and have your advisor attach a
program plan checklist. ( C ) Complete the Student Exit Survey. The web address for the survey is:https://survey.somerset.kctcs.edu/blue/a.aspx?l=39_2_AAAAAAAAAaY . You will use your KCTCS user name and password to log in to
the survey. ( D ) Return the completed application to the SCC Student Records Office. Name_________________________ __________________ ________________________________________________ Empl ID #__________________________________ Phone Number______ ___________________________________ Program Major___________________________________________________________ ________________________Advisor’s Name _______________________________Advisor’s Signature__ _____ ____________________________
Last Date Attended Classes at SCC ____________________________Mailing address for credential _______________________________________________________________________
(City, State , Zip)Name to be printed on credential______________________________________________________________________
( Please print clearly ) Please list all credential(s) you are requesting: ___ Associate in Arts __ _ Associate in Science ___ Associate in Applied Science Major__________________________________________________________ ___ Diploma Title___________________________________________ ________________ ___ Diploma Title___________________________________________________________ ___ Certificate Title___________________________________________ ________________ ___ Certificate Title___________________________________________ ________________ ___ Certificate Title___________________________________________ ____ ____________ ___ Certificate Title___________________________________________ ________________ ___ Certificate Title___________________________________________ ________________ ___ Certificate Title___________________________________________ ___________ _____ ___ Certificate Title___________________________________________ ________________ ___ Certificate Title___________________________________________ ________________By signing this application, I give the college permission to award embedded credentials within my program.
I give permission for SCC to release my contact and credenti al information to potential employers. ___YES ___NO
