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Application for Graduation or Certificate Completion

2014-2015 Commencement Year

Please complete both sides of this form and return to the Registrar’s Office, F-111, by the appropriate deadline. Submit one application for each program you expect to complete.  

Check expected graduation date:

August 31, 2014                  Application deadline is July 25, 2014

December 31, 2014            Application deadline is November 21, 2014

May 29, 2015                      Applications deadline is March 6, 2015

 
Student Information:


Name:    ______________________________________________________________________________________________


Student ID: __________________________________    or    Social Security No. ______________-___________-__________

 

Current Address and Phone:

 

_________________________________________         __(__________)___________________________________________

Street Address                                                                                                                                      Phone

 

_____________________________________________________________________________________________________

City                                                                                         State                                                                               Zip

 

Diploma Information:

Please print your name exactly as you wish it to appear on the diploma or certificate.   Changes cannot be made after diplomas are printed.

 

_____________________________________________________________________________________________________

First Name                                                                       Middle                                                                Last Name

 

August and December graduates, as well as May/June graduates who do not attend the Commencement

ceremony, are mailed diplomas about 2-4 weeks after the graduation date. Please provide us with a diploma mailing address if different from your current address.

 

_____________________________________________________________________________________________________

Street Address

 

_____________________________________________________________________________________________________

City                                                                                      State                                                                  Zip

 

Other Information:

·         If you are applying for a degree, you must fulfill the Forum, Health/Fitness and, if applicable, the Core Competencies Portfolio requirements to qualify for graduation. They do not need to be complete at the time of application.

·         The Registrar’s Office will conduct a degree audit of your records to determine if you have completed all the requirements for graduation. You will be notified of the results.

·         If you do not complete all of the requirements, you must re-apply for a later graduation date.

·         The College graduates students in August, December and May/June of each year. A single Commencement ceremony is held each year in May or June. August and December graduates have their completion noted on the transcript and receive a diploma in the mail shortly after the graduation date. They are invited to attend the following May/June commencement ceremony.

 

Student Signature:
I am applying to graduate or complete a certificate from BCC.
  

 

__________________________________________________         _______________________________________________ 

                                                    Signature                                                                                                                        Date                          

  

    

        

Berkshire Honors Scholar Program: (circle the correct answers)

  •   Are you a participant in the Berkshire Honors Scholar Program?      YES              NO
  •   If yes, do you plan on completing the requirements necessary
      to graduate with the Berkshire Honors Scholar designation?                YES                   NO

 

 

Program of Study
Please check one program.

 

A.A. Degree Programs

___  A.A. Business Administration
___
  A.A. Fine Arts (Music)
___
  A.A. Fine Arts (Theatre Arts)
___
  A.A. Fine Arts (Visual Arts)
___
  A.A. Liberal Arts
___
   A.A. Liberal Arts (Atmospheric Science)
___
  A.A. Liberal Arts (Biological Science)
___
  A.A. Liberal Arts (Biotechnology)
___
   A.A. Liberal Arts (Early Childhood Education)
___
  A.A. Liberal Arts (Elementary Education)
___
  A.A. Liberal Arts (Foreign Language)
___
   A.A. Liberal Arts (International Studies)
___   A.A. Liberal Arts (Peace and World Order Studies)

  

 

Certificate Programs

___  Animal Care
___
  Applied Manufacturing Technical Skills
___
  Applied Manufacturing Technology
___
  Business Software
___
  CIS Networking
___ 
CIS Programming (Business)
___
  CIS Programming (Technical)
___
  Culinary Arts
___
  Early Childhood Education - Introductory
___
  Early Childhood Education - Intermediate
___ 
Health Information Management
___
  Human Services
___
  Lodging Management
___
  Massage Therapy
___
  Medical Coding Technical Skills
___
  Music Production
___
  Physical Fitness
___   Practical Nurse      

A.S. Degree Programs 

 

Are you planning to complete the additional coursework
needed to meet the MassTransfer Block?

    ___   Yes       ___  No                  

___   A.S. Business Careers
___
  A.S. Business Careers (Health Information Management)
___
  A.S. Business Software Systems
___
  A.S. Computer Information Systems (Business Systems)
___
  A.S. Computer Information Systems (Computer Science)
___
  A.S. Computer Information Systems (Networking)
___
  A.S. Criminal Justice
___
  A.S. Early Childhood Education
___
  A.S. Engineering
___
  A.S. Engineering Technology (Computer/Electronic Technology)
___  
A.S. Engineering Technology (Manufacturing Technology)
___
  A.S. Environmental Science
___
  A.S. Fire Science
___
  A.S. Health Science
___
  A.S. Health Science (Dental Assisting)
___
 A.S. Health Science (Medical Assisting)
___
 A.S. Health Science (Physical Fitness)
___ 
A.S. Health Science (Surgical Technology)
___
  A.S. Hospitality Administration (Career)
___
 A.S. Hospitality Administration (Transfer)
___
 A.S. Human Services
___  
A.S. Human Services (Social Work Transfer
___
 A.S. Nursing
___
 A.S. Physical Therapist Assistant
___
  A.S. Respiratory Care

   
       


 Revised 6/14