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LTC Application for Graduation

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Application for Graduation

Your name will appear on your diploma as the first name and last name that Lakeshore has on record for you in the system.

The home (personal) email address that Lakeshore has on record for you will be the email account used to send you information regarding your diploma from Parchment.

If any corrections are needed, you are responsible to make the changes on your Student Center account.

Student ID Number

First Name

Last Name

Address:

City:

State

Zip:

What semester do you plan to graduate?

What year do you plan to graduate?

What type of credential do you plan to graduate from?

Associate Degree Program:
(Note: You may be awarded any additional credentials that are embedded in your program.)

Technical Diploma:

Certificate Program:

Are you planning to graduate from another program or embedded credential in the same semester?

Type of Degree

Associate Degree Program:
(Note: You may be awarded any additional credentials that are embedded in your program.)

Technical Diploma:

Certificate Program:

Type of Degree

Associate Degree Program:
(Note: You may be awarded any additional credentials that are embedded in your program.)

Technical Diploma:

Certificate Program:

Type of Degree

Associate Degree Program:
(Note: You may be awarded any additional credentials that are embedded in your program.)

Technical Diploma:

Certificate Program:

Type of Degree

Associate Degree Program:
(Note: You may be awarded any additional credentials that are embedded in your program.)

Technical Diploma:

Certificate Program:

The graduates' names and programs are published in the newspaper by Lakeshore. If you do not want your information published or released to anyone, please contact Student Records at 920-693-1888 or ltc.records@gotoltc.edu.

If you have not met your graduation requirements, you are required to submit a new Application for Graduation each time you register for the last course(s) in your program.

By submitting this form, I certify that all information on this application is representative of myself. I give permission to use the information on this form for processing any of Lakeshore's graduation processes.

First Name:

Last Name:

Date:

Lakeshore College does not discriminate against protected classes, including but not limited to race, color, national origin, religion, sex, or gender – including sexual orientation, gender identity, gender expression, disability or age in employment, admissions, or its programs or activities. To handle inquiries regarding Lakeshore's nondiscrimination policies, contact the Mgr-Access, Equity, & Inclusion (students) 920.693.1120, nicole.yang@gotoltc.edu / Executive Director of Human Resources (staff/others) 920.693.1158, marissa.holst@gotoltc.edu. 1290 North Avenue, Cleveland, WI 53015. TTY 711 gotoltc.edu/equal-opportunity-statement

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