Intent to Graduate – River Valley Community College

Student ID#*
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Email Address*
Telephone #*
Program*
(Please submit a separate form for each program you intend to graduate from.)
- Associate Degree
- Certificate
(Please submit a separate form for each program you intend to graduate from.)
Name exactly as you would like it to appear on your diploma*
(This is where you can decide if you want your middle name or initial, a formal first name or a shortened version, etc.)
Anticipated Graduation Date*
- December 23, 2020* (Intent to Graduate form due October 1, 2020)
- May 14, 2021* (Intent to Graduate form due February 1, 2021)
- August 11, 2021* (Intent to Graduate form due February 1, 2021)
(*See Student Handbook for information on graduation requirements and policies. Please complete an audit with your advisor to ensure you are on track for the selected graduation date. Please note, a decision has not yet been made regarding the type of ceremony, if any, that will be held in May.)
Do you plan to participate in the graduation ceremony on May 14, 2021?*
- Yes
- No
If you plan to walk, but have remaining credits to finish in the Summer 2021 term, please submit the Exception to Participate in Graduation Exercises On May 14, 2021 Request Form to the Office of Academic & Student Affairs. Please ensure you are registered for those classes required to finish.
Signature*
Date*
Date Format: MM slash DD slash YYYY