Petition to Graduate Form - Fort Scott Community College

Full Name(Required)

This is how your name will appear on your diploma

Date of Birth

Student ID(Required)

Personal E-mail(Required)

FSCC E-mail(Required)

Cell Phone

Diploma Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Graduation Information

Year of Graduation (YYYY)(Required)

Which semester are you applying for?(Required)

Fall

Spring

Summer

Are you applying for a degree or a certificate?**(Required)

Certificate**

Associate in Applied Science**

Associate in Arts

Associate in Science

Associate in General Studies

**If applying for a certificate, indicate which program:(Required)

**If applying for an Applied Science degree, indicate which program:(Required)

Are you a Reverse Transfer Student?(Required)

Yes

If yes to Reverse Transfer Student above please indicate which college you will be transferring your credits back from(Required)

Are you planning to attend the graduation ceremony held in May at the Fort Scott campus?(Required)

Yes

Are you a member of Phi Theta Kappa?(Required)

Yes

Are you a veteran or current military service member?(Required)

Yes

With your completion of this graduation application, an official evaluation of your transcript will occur. Please check your FSCC student email for further correspondence regarding graduation.

By entering your signature below and pressing submit, you are accepting that a non-refundable graduation fee of $50 will be billed to your account before you receive your diploma or transcript. Check your MyFSCC account to ensure the $50 graduation fee has been applied. If the charge is not listed on your account please make payment arrangements with the cashier’s office by calling 620-223-2700 ext. 5090.

You also accept that you must consult with your advisor to have a degree audit performed before graduation.

Fees are subject to change.

Student's Signature(Required)

Signature Date(Required)

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