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
Doctor of Nursing Practice

Bachelor of Arts Honors
Bachelor of Science Honors
Bachelor of Science in Nursing Honors
Master of Education
Master of Arts in Religion
Master of Arts in Christian Ministries

Year and Month all requirements will be completed:

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

Do you plan to attend a Commencement ceremony?   Yes   No  
If yes, which one do you plan to attend?   Lamoni - May   Independence - December*
      *Only option for Bachelor of Science in Nursing, Health Care Management, and all Master or Doctoral degree candidates. All other candidates may choose to attend either Independence - December or Lamoni - May.

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:


At the time you apply to graduate, a $75.00 Graduation Fee will be charged to your student account. Please remit payment as soon as possible. Payment options include: pay online at www.graceland.edu/payonline, pay by phone toll free at (866) 786-2792, or pay by mail: Graceland University, Student Accounts, 1 University Place, Lamoni, IA 50140.