Please print name in Full:                                                    Date:_____________

____________________________________            ID#:  ____ - ___ -____
Last                          First                      MI
 

DEGREE APPLYING FOR: (Check one)                                EXPECTED GRADUATION DATE: (Check one)

____________Associate Degree                                                      _____ May

 ___________Baccalaureate Degree                                                 _____August              Year:________

 ___________Masters Degree                                                          _____December

___________Certificate of Advanced Study
 

MAJOR:__________________________________                MINOR:__________________________
 

Please print your full legal name as you would like it to appear on your diploma:

________________________________________________________________________________
 

Your home town and state as it should appear in the Commencement Program:

_________________________________________________________________________________

Information concerning the Commencement Ceremony will be mailed in March and April. This information will be mailed to you at the address on file at that time. Please keep your address updated!
 

Address to which your diploma should be mailed:

Street________________________________________________________

City_________________________________________ State______________ Zip_____________

THIS FORM SHOULD BE SUBMITTED TO THE REGISTRAR'S OFFICE ON THE GORHAM CAMPUS, THE ENROLLMENT SERVICES OFFICE ON THE PORTLAND CAMPUS OR AT AN OFF-CAMPUS SITE. IF YOU CHOOSE TO MAIL IT, MAIL DIRECTLY TO THE REGISTRAR'S OFFICE, USM, 37 COLLEGE AVENUE, GORHAM, ME 04038.