Fillable Printable Graduate Certificate Completion Form - Kansas

Graduate Certificate Completion Form - Kansas

GRADUATE CERTIFICATE COMPLETION FORM

Submit original to:

Graduate School

103 Fairchild Hall

List courses completed for certificate program

Total KSU Credits

Is this certificate to be prepared by the Graduate School?

Note: Credits that were earned more than six years prior to the semester in which the certificate is

approved cannot be accepted.

I hereby verify to the best of my knowledge that this student has or will have met the requirements of

completion for this certificate program by the end of this semester.

________________________________________________

Signature of certificate program coordinator

________________________________________________

Name of certificate program coordinator (Please Print)

________________________________________________

Date

Student Name:

Student Number:

K-State eID:

Certificate Program:

Semester of completion:

Dept

Code

Course

Number Course Name

Credits

Semester

Taken

Date Needed

For GS Use Only:

______ ED

______ CC

______ C - DW

______ STD