Clinton Community College

Graduation Application

You should complete and submit this form at least one semester prior to the semester in which you will be completing your graduation requirements. Once you complete the form, the results will be emailed to the Registrar's Office and a copy will be sent to the email address you provide below.

DISCLAIMER: Appearance of your name in the CCC program or participation in the ceremony is not official evidence of degree completion.

Please consult an academic advisor in Student Services, or the Registrar, prior to adding or dropping classes after you apply for graduation. Failure to do so may result in delaying your graduation.

Asterisk (*) indicates a response is required.

Date and Time: Saturday December 4, 2021 19:59
Please type your name as you wish it to appear on your diploma.
* First Name:

* Middle Name:

Indicate with "none" if you do not have a middle name.
* Last Name:

* Email:
* Student ID:
If you do not know your student id number go to and log into EICC Connect. Once you are logged into EICC Connect, your student ID will appear in the top right corner.
* Address:

* City:

    *Zip: *Phone Number:     


I DO DO NOT plan to attend the ceremony in May.

If you will be attending, you must order a cap and gown.

Height: inches   
Height and chest measurement in inches is required by the vendor of the cap and gown in order to get a proper fit.

Expected Date of Completion: Fall * Spring     Summer  

Year of Completion:

* CCC holds one Commencement Ceremony for all participating graduates. The Commencement Ceremony will be held May at Clinton High School Yourd Gymnasium. There is NO CHARGE to participate. Watch EICC Connect for more details.

* Those who apply for Fall Graduation would participate in our May graduation ceremony.

Specialized physical needs requiring accommodations:

* PTK Member: Yes      No

* Do you have any transfer work? Yes      No
If yes, please provide the name of the college/university:
Please separate multiple college names with commas.

* Check Degree:
Associate in Arts Degree in Liberal Arts
Associate in Science Degree in Liberal Arts
*Associate in Applied Science Degree
*Diploma Only
*Certificate Only

*If you indicated an Associate in Applied Science Degree, Diploma and/or Certificate above, please indicate from the list below, the specific program.

Administrative and Office Support AAS (AO.C.AAS)

Administrative Support Diploma (AO.C.DPL)

Office Support Certificate (AO.C.CERT)

Computer Applications for the Office (AOCA.C.CERT)

Administrative & Office Support - AAS/MCC (AO.E.AAS)

Administrative & Office Support - DPL/MCC (AO.E.DPL)

Accounting & Office Support - CERT (AO.E.CERT)

Business Management AAS (BUMG.E.AAS)

Management Supervision Certificate (MS.C.CERT)

Marketing Certificate (MK.C.CERT)

Small Business Management Certificate (SB.C.CERT)

Entrepreneurship - Certificate (BUEN.E.CERT)

Dental Hygiene - AAS Degree

Advanced Emergency Medical Technician AAS (EMTADV.E.AAS)

Advanced Emergency Medical Technician Certificate (EMTADV.E.CERT)

Emergency Medical Technician Certificate (EMT.E.CERT)

Engineering Technology (ET.E.AAS)

Engineering Technology Electromechanical AAS (ETE.E.AAS)

Engineering Technology Process Control AAS (ETP.E.AAS)

Engineering Technology Diploma (ET.E.DPL)

Engineering Technology Basic Electronics (ETT.E.CERT)

Engineering Technology Basic Electricity (ETC.E.CERT)

Graphic Arts Technology -- AAS (GA.C.AAS)

Graphic Arts Diploma (GA.C.DPL)

Health, Safety and Environmental Technology AAS (HSET.S.AAS)

Health, Safety and Environmental Certificate (HSET.S.CERT)

Information Technology

IT/Cybersecurity - AAS Degree

IT/Database Concentration - AAS Degree

IT/Games and Simulations Concentration - AAS Degree

IT/Augmented Reality - Diploma

IT/Hardware/Help Desk Administration Concentration - AAS Degree

IT/Networking Concentration - AAS Degree

IT/Programming Concentration - AAS Degree

IT/Server Administration Concentration - AAS Degree

IT/Security and Forensics Concentration - AAS Degree

IT/Web Development Concentration - AAS Degree

IT/Networking - Diploma

IT/Programming Concentration - Diploma

Mechanical Design Technology (MD.E.AAS)

CAD/Pro-Engineer-Diploma (MD.E.DPL)

CAD/Pro-Engineer-Certificate (MD.E.CERT)

Solid Modeling/Pro-E-Certificate (SMPE.S.CERT)

Mechatronics Technology AAS (MCT.C.AAS)

Mechatronics Diploma (MCT.C.DPL)

Medical Assistant

Medical Assistant - Diploma

Nursing AAS (ADN.C.AAS)

Practical Nursing Diploma (PNE.C.AAS)

Physical Therapist Assistant (PREPTA.E.AAS)


Production Welding Certificate (PWE.C.CERT)

Technical Studies AAS (TS.C.AAS)

Statement of Agreement: By checking this box, I acknowledge that the above information is correct. I also acknowledge that the appearance of my name in the CCC program or participation in the ceremony is not official evidence of degree completion. I understand that I must consult an academic advisor in Student Services, or the Registrar, prior to adding or dropping classes after I apply for graduation. Failure to do so may result in delaying my graduation.

It is the policy of Eastern Iowa Community College District not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, gender identity, creed, religion, and actual or potential family, parental or marital status, as required by the Iowa Code §§216.6 and 216.9, Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d and 2000e), the Equal Pay Act of 1973 (29 U.S.C. § 206, et seq.), Title IX (Educational Amendments, 20 U.S.C. §§ 1681-1688), Section 504 (Rehabilitation Act of 1973, 29 U.S.C. § 794), and Title II of the Americans with Disabilities Act (42 U.S.C. § 12101, et seq.).

If you have questions or complaints related to compliance with this policy, please contact Debora J. Sullivan, Equal Employment Opportunity Officer/Equity Coordinator, Eastern Iowa Community College District, 101 West Third Street, Davenport, Iowa 52801, 563-336-3487, or the Director of the Office for Civil Rights, U.S. Department of Education, Citigroup Center, 500 West Madison Street, Suite 1475, Chicago, Illinois 60661-7204, phone number 312-730-1560, fax 312-730-1576,