Graduation Candidate Diploma Form

(To be completed and returned by all graduation candidates for terms indicated below)

Anticipated Graduation Term: *

Fall 2012

Spring 2013

Summer 2013

Student ID Number: *

Please enter your Student ID Number (SUid). This number is nine digits long and begins with the number "9".

E-mail Address:

Diploma Name: *

Please type your name exactly as you would like it printed on your diploma.

Hometown: *

Only one may be listed for the commencement program and newspaper notification.

Local Phone Number: *

Local Address

Street Line 1: *

Street Line 2:

City: *

State: *

Zip: *

Permanent Address

Street Line 1: *

Street Line 2:

City: *

State: *

Zip: *

Please check one of the following: *

I walked early in a Commencement Program.

I plan to attend the Fall 2012 Commencement on December 15.

I plan to attend the Spring 2013 Commencement on May 17.

Please check one of the following: *

I will pick up my diploma in Samford Student Records. (You will receive e-mail notification via your Samford account when diplomas are ready.)

Please mail my diploma to me at this address:

Address to send diploma:

Street Line 1:

Street Line 2:

City:

State:

Zip:

This correspondence is not a guarantee that you will graduate when anticipated, nor is it a certification that you have completed all requirements for graduation. Please contact me at pjnelson@samford.edu or by phone at 205-726-2222 with any questions or concerns.

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Page last updated: Tue, 09/04/2012 - 09:59