SCC Graduation Application

Asterisk (*) indicates a response is required.

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 SCC 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.

The name you enter below, is how your name will appear in the program (if attending the ceremony) and on your degree, diploma and/or certificate.

*First Name:
*Middle Name:
*Last Name:
*Phone Number:
*Student ID:

If you do not know your student ID, please go to eicc.edu/eicconnect and log into EICC connect. Your student ID will appear in the top right corner.
*Address:

The address listed here is where your diploma will be mailed.

*City:
*State:
*Zip:
*E-mail:

Anticipated Completion Date

*Semester: Fall Spring Summer
*Year:

Degree which you are applying for:

*Award type:

Associate in Arts Degree

Associate in Science Degree

Associate in Applied Science Degree

Diploma

Certificate

Commencement

We hold one Commencement Ceremony in May for all graduates, Fall, Spring, and Summer.

*Do you plan to participate in the ceremony? Yes No

If yes, please enter the following for cap and gown order:
*Height:
*T-shirt Size:
*Weight:
*If attending, please enter the phonetic spelling of your name.
Example: Jessica Smart [Jeh-see-kah Sma-art]
*Phi Theta Kappa Member? Yes No
*Veteran/Military Service? Yes No
*Will you need special accommodations for the ceremony? If so, how may we assist?

*Application approval is contingent upon successful completion of courses to be used to meet degree requirements. If your application for the degree requested, is not approved for the semester/year indicated on this application, you must re-apply for the degree as of the appropriate date, indicated by the Registrar. Your submission of this form and acknowledgment serves as your electronic signature for this graduation application request. This also serves as your signature that Scott Community College can put your name in the program for commencement, if you said you are attending the Commencement ceremony.

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 EICC’s Equal Employment Opportunity Officer/Equity Coordinator, Eastern Iowa Community College District, 101 West Third Street, Davenport, Iowa 52801, 563-336-5222, equity@eicc.edu or the Director of the Office for Civil Rights U.S. Department of Education, John C. Kluczynski Federal Building, 230 S. Dearborn Street, 37th Floor, Chicago, IL 60604-7204, Telephone: (312) 730-1560 Facsimile: (312) 730- 1576, TDD (800) 877-8339 OCR.Chicago@ed.gov.