Registrar's Office

North Dakota State College of Science
Graduation Petition Form

I have met all the graduation requirements and I request that I be permitted to graduate. The following information about myself is submitted for use by the graduation committee.
First name:

Middle initial:

Last name:

Empl ID#:

Date of birth:
(mm/dd/yyyy)
Hometown:

State:

Phone number:

E-mail address:

Academic option (major):

Emphasis/Option:

I am applying for:

Term of completion:

Credits from another college are used towards graduation:

I will be transferring to another College or University:

What College or University are you transferring to: (Please list below)

I will be returning to NDSCS:

If you are returning to North Dakota State College of Science you must complete the Continuing Student Enrollment form before registering for the next term after graduation.
I will be attending the graduation ceremony:

Graduation caps and gowns maybe purchased at the NDSCS Bookstore.
Do you have a disability or impairment that requires special accommodations for graduation. If yes, what special accommodations are needed please list those below:
Please list special accommodations if needed.
In the box below list where you would like to have your award sent to: (Complete address)
Please enter your complete mailing address.
I certify to the best of my knowledge, by entering your full legal name that the information on this form is complete and true without evasion or misrepresentation. I understand that if found to be otherwise, it is sufficient cause for rejection.
Enter your full legal name: