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Certificate Application

* indicates required field
 
Please wait 2 to 3 business days after receiving your acknowledgement email before paying the required $30 fee for this application. This fee will be assessed to your student account 2-3 days after submitting your applications; payment must be made immediately thereafter to avoid a hold on your student account. Please pay this fee either in Genisys (make a credit card or webcheck payment to your student account by clicking on the Tuition and Fees Online Payment tab), or pay in person with cash or check at the Business Office. If this application is denied, this fee will apply to the next term in which the student applies.
 
Please choose which certificate you are applying for:  *
Please choose the concentration of your certificate: 
Term: * Year: *
Note: Students who are denied clearance for their certificate in the term stated on this application must file another application in the subsequent term in which all requirements for the certificate have been met.
Type your name exactly as you wish it to appear on your certificate.
First Name:  *
Middle Name: 
Last Name:  *
Suffix: 
Student ID:  *
Email Address:  *
School:  *
Program: *
Major: *
Advisor: *
 
Important: If more than one certificate concentration is being applied for, please fill out and submit separate applications for each concentration. These candidates must pay two certificate fees.
 

Certificate Mailing Address**

Street: *
Apt. #:
City: *
State: *
State/Country (if not listed above):
Zip Code: *
International Tracking Requested?* Yes  No
*NOTE: Additional fees will apply for International Tracking, ranging from $60 to $130. Please contact the Registrar's Office for information on these fees
**PLEASE NOTE: Please check your Genisys account after graduation to make sure you have an accurate forwarding address on file and update if necessary. If no address is provided, your diploma will be mailed to your final active address listed in Genisys. If your diploma is returned as undeliverable, additional fees will apply to ship your documents to a forwarding address.