Personal Information Full Name * This is how your name will appear on your diploma. Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018 Student ID * Personal E-mail * FSCC E-mail Cell Phone Diploma Mailing Address * City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Code * Graduation Information Year of Graduation * Which semester are you applying for? * Fall Spring Summer Are you planning on attend the graduation ceremony held in May at the Fort Scott campus? * Yes No Are you a member of Phi Theta Kappa? * Yes No Are you a Reverse Transfer Student? * Yes No What school are you reverse transferring from? * Are you applying for a degree or a certificate? * Degree Certificate Please select the degree you're applying for * Associate Degree in Arts (AA) Associate Degree in Science (AS) Associate Degree in General Studies (AGS) Associate Degree in Applied Science (AAS) Applied Science Field * Construction Trades Cosmetology Criminal Justice Environmental Water Technologies Farm and Ranch Management Harley Davidson Motorcycle Service Technology Heating, Air Conditioning & Refrigeration John Deere Agricultural Technology Nursing Please check the certificate you're applying for * Construction Trades Cosmetology Criminal Justice Environmental Water Technologies Farm & Ranch Management Heating, Air Conditioning & Refrigeration Manicuring Masonry Welding With your completion of this graduation application, an official evaluation of your transcript will occur. Please check your FSCC student email for further correspondence regarding graduation. By entering your signature below and pressing submit, you are accepting that a non-refundable Exit Exam fee of $30 must be paid to the Cashier's office before you receive your diploma. (Note: If you are/were enrolled in Capstone (EDU2301, NUR2531, HDT2064, AGT2033) this fee has already been billed to your student account) You also accept that you must meet with your advisor to have a degree audit performed before graduation, and that you must take the Exit Exam (AA, AS, & AGS will take the ETS Proficiency Profile Exam – AAS will take the WorkKeys). Finally, you accept that these scores may be placed on your official transcript. Fees are subject to change. Student's Signature * Signature Date * Month MonthOct Day Day21 Year Year2018
