Graduation Participation Form

HUMPHREYS UNIVERSITY

Graduation Participation Form

Petition must be filed with the Registrar no later than the first week of the spring quarter.

Student Information

Student Type *

Student ID Number: *

Please spell your name exactly the way you want it to appear on your diploma:

First Name *

Middle Name

Last Name *

Mailing Address *

Address Line 2

City *

State *

Zip Code *

Cell Number *

Home Number

Email Address *

Academic Information

Degree *

Major/Course of Study *

Minor (if applicable)

Commencement

Commencement Program *

YES, print my name in the commencement program.

NO, DO NOT print my name in the commencement program.

Commencement Ceremony *

YES, I will participate in the commencement ceremony.

NO, I will not participate in the ceremony; however, I will order a diploma.

NO, I will not participate in the ceremony, and I do not want to order a diploma.

Please note: Graduation fee of $100 must be paid before items are ordered.

Height for Graduation Gown (Please include feet and inches) *

Weight for Graduation Gown (lbs) *

Please note: There is a diploma fee of $25.

Signature

Student Signature: *

clear

Today's date * +