AUGUST GRADUATION

 

(December commencement ceremony)




PART I
Application for Degree
Office of the Registrar
(815) 836-5217
 
* Required  
*Student ID:
*Name:
[Please FILL IN EXACTLY as you wish it to appear on diploma.]

NOTE: Please contact Registrar's Office if your name contains multicultural accents.
 
*Name Phonetic Pronunciation:
Sample Name: Beethoven      Pronunciation: Bay-toe-ven
 
Current Address [Where we can contact you PRIOR TO Graduation.]
*Address:
*City:
*State:
*Zip Code:
   
Home Address [Where we can contact you AFTER Graduation.]
                                                   Copy from Current Address:
*Address:
*City:
*State:
*Zip Code:
   
Phone(s):
*Daytime Phone:
*Cell Phone:
   
*Lewis Email Address (all correspondence will be sent to this email):
 
*Please re-enter Lewis Email Address:
 
Other Email Address:
 
Please re-enter Other Email Address:
*College [Check one]
Arts and Sciences Education
Business Nursing and Health Professions
 
*Degree [Check one]
2-yr Aviation (06) Associate (08) Bachelor's
Master's Certificate of Advanced Study Doctorate
   
Major: 1)
  2)
Minor: 1)
  2)
 
   
Please Note: If for any reason you find that you will not graduate on the date designated above, please contact the Registrar's Office and withdraw your application. You must re-apply for a future date. Your application is not carried over automatically to the next graduation date.
 

PART II

 
TRADITIONAL UNDERGRADUATE
Directions: Your responses to the following questions will provide us with important feedback about your experience at Lewis.
 
*Please check the box that best describes your plans for after graduation.
I plan on working
I plan on attending graduate school
I plan on working and also attending graduate school
I am still deciding what i would like to do after graduation
I do not know what I want to do after graduation
Other (Please Describe)
 
If you know where you will be working or enrolled in graduate school please indicate below.
 
Employer:
Title:
Location:
   
and/or
   
Graduate School:
Program:
Degree:
Location:
 
*How closely will your career or graduate school plans be related to your major field?
Very closely related
In the same general area
Slightly related
Not at all related
I don't know
 
*Please indicate your level of agreement with the following statement:

My academic degree program at Lewis has prepared me with the knowledge, skills, and abilities to enter or advance a career, or to begin graduate study.
Strongly Agree
Agree
Somewhat agree
Disagree
Strongly disagree
Please check all activities that you participated in while a student at Lewis.
Internship
Study Abroad
Community Service
Research project
Student_Organizations
Career preparation workshops and counseling
Campus Ministry
Leadership opportunities
Other: 
   
*Would you be interested in providing a short testimonial on your experiences at Lewis that could be shared with future students?
Yes
No
Any other comments you would like to share?
 
 
 
*Signature:
Date: 6/19/2013