Application for Degree

It is IMPERATIVE that you complete this application in order to be issued a diploma.

Name

Please ENTER your name EXACTLY as you want it to appear on your diploma, in upper and lower cases.

First: 

Middle: 

Last: 

Medical Center ID #: 

Address

Your Home Town (for the University Commencement Program)

City:  State: 

Address After Graduation (if known)

Street Address: 

City:  State:  Zip Code: 

Country: 

Parent(s)/Home Address

Street Address: 

City:  State:  Zip Code: 

Country: 

Current Columbus Mailing Address

Street Address: 

City:  State: 

Zip Code:  Country: 

Undergraduate Information

For the University Commencement Program, please list college(s) attended and degree(s) received

Degree:  Name of College: 

City:  State: 

Degree:  Name of College: 

City:  State: 

Degree:  Name of College: 

City:  State: 

YES, I will be attending the University Commencement
NO, I will NOT be attending the University Commencement

If you have answered “No” above, please download the commencement absence form. You must complete and submit this form to our office by May 15. This form must be completed and submitted if you do not plan to attend commencement. The information you provide is essential to receive your diploma.