NOTICE OF INTENT TO GRADUATE
PRINTED NAME TO APPEAR ON DIPLOMA: PRINT CITY, STATE OR COUNTRY YOU WISH ANNOUNCED AT COMMENCEMENT: _____________________________________________________________________________________________ HOME ADDRESS: Number and Street City State Zip Code _______
Number where you may be reached prior to graduation Upon successful completion of prescribed requirements I will receive a: Bachelor of Arts Degree in Bachelor of Science Degree in Concentration (s) Minor (s)
Which catalog are you fulfilling the requirements of for your major, minor and/or concentration? _____-_____
ALL CANDIDATES MUST BE PRESENT AT GRADUATION EXERCISES*
Date
Student Signature
First Major Advisor
Second Major Advisor
First Concentration Advisor
Second Concentration Advisor
Division Chair (Major 1)
Division Chair (Major 2)
After all the signatures are obtained, please take this form to the Office of the Registrar in the Nichols Administration Building by the end of the spring semester preceding the senior’s last fall semester . A completed Degree Plan must accompany this Intent for it to be accepted.
Please list members of your immediate family (Father, Mother, Grandmother, Grandfather, brother, sister, spouse, son, or daughter) who have graduated from Lyon College so they may be acknowledged at graduation.
NAME RELATION YEAR GRADUATED
*The Dean of the Faculty may exempt from this requirement any student who has completed graduation requirements prior to the beginning of the spring semester, who resides out of the state of Arkansas, and who requests such exemption IN WRITING no later than April 1 of the year in which the student expects to graduate. Lyon College will only award one degree per student.