ID Number Campus Box Number
E-mail Phone

Your name as you want it to appear on your diploma (first, middle, last):

Your hometown as you want it to appear on the commencement program:

Degree:
Bachelor of Arts Bachelor of Science Bachelor of Science in Nursing Bachelor of Science in Nursing/ Master of Science in Nursing Master of Science in Nursing	Bachelor of Arts (Honors)* Bachelor of Science (Honors)* Bachelor of Science in Nursing (Honors)* *Honors program applicable to campus students only Master of Education Master of Arts in Religion Master of Arts in Christian Ministries

Year and Month to be conferred:

January February March April May June
July August September October November December

Commencement will be held in May. Do you plan to attend? Yes No

Mailing Address for your diploma:

Address:
City:
State:
Zip:
Country:

Major(s):

Concentration/Emphasis/Option/Track:

Minor(s):

Teacher Education:
Combination (K-12)
Secondary (7-12)
Elementary (K-6)

Teaching Subject Areas:

Name of Academic Adviser:

A graduation fee of $50.00 is assessed to candidates for graduation. This fee will be charged to your student account when you apply to graduate. Please remit payment as soon as possible by personal check or money order to: Graceland University, Student Accounts, 1 University Place, Lamoni, IA 50140 or call Student Accounts toll free at (866) 786-2792 to pay by phone.