Application for Completion of the Graduate Certificate by keithmurray

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									             Office of the Graduate College




                                            APPLICATION FOR COMPLETION
                                            OF THE GRADUATE CERTIFICATE

  I. I expect to complete certificate requirements for the following term: (               Dec.,          May,      August):

 II. Please TYPE your name as you wish to have it appear on your certificate:

        Mr.
        Mrs.
                            First Name                              Middle, Maiden or Other Name                  Last Name
        Ms.
        Dr.

III. BGSU ID:

IV. Local Address (used for Graduate College mailings PRIOR to commencement ceremonies):

     Street Address                                                                                          Daytime Phone (include area code)


     City/State/Zip                                                                                          Nighttime Phone (include area code)

 V. Certificate Mailing Address (if different from above):

     Street Address                                                                                          Daytime Phone (include area code)


     City/State/Zip                                                                                          Nighttime Phone (include area code)

VI. BGSU E-mail address:

VII. Certificate sought:

                                                                                             FOR OFFICE USE ONLY
        Bioinformatics, Proteomics/Genomics                                          PIDN/Name
        Ethnic Studies                                                               Admission Status/PVDG
                                                                                      CPS Submitted
        Food and Nutrition
                                                                                      Registration Status
        Geospatial Technology/Geology                                                Transfer Credit
        Gerontology                                                                  HOLD/NOTE
         International Scientific and Technical Communication                        STUD/ADVR/TSUM
                                                                                      Capstone Completed
        Organizational Change
                                                                                      Course Revalidation
        Public History                                                               Ackl. Appl. Ltr.
         Quality Systems                                                             Copy to R & R
        Women’s Studies




     Student Signature (not required if submitted electronically)                         Date
                                                                                                                                         gc:12/08

								
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