CHANGE OF DEGREE COMPLETION DATE REQUEST Plan ahead

CHANGE OF DEGREE COMPLETION DATE REQUEST
STOP:
NOW:
WHAT THIS WILL DO:
Office of the Registrar
Do not complete this form if any of the situations on the reverse apply.
Complete this form only if you are a currently enrolled/registered student.
If approved, this form will allow you to register for subsequent terms, and will determine
when we process your final degree check.
You will not be able to register beyond your stated degree completion term, and undergraduates will
not receive any additional graduating senior registration rotations.
Plan ahead; this form requires approval by your college.
PRINT NAME:
___________________________________________________________
EMPL ID ____________________________________________
ADDRESS:
___________________________________________________________
PHONE #____________________________________________
CITY/STATE:
________________________________
MAJOR:____________________
ZIP:____________________
CIRCLE ONE:
CAL POLY EMAIL ADDRESS: _____________________
Undergraduate
Graduate
NEW TERM AND YEAR ALL DEGREE REQUIREMENTS WILL BE COMPLETED:_____________________________
PREVIOUS TERM AND YEAR DEGREE WAS TO BE COMPLETED:__________________________________________
PLEASE STATE IN DETAIL YOUR REASON, OR REASONS, FOR REQUESTING TO EXTEND YOUR GRADUATION TERM.
BE AS SPECIFIC AND THOROUGH AS POSSIBLE: ________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
__________________________________________________________________
Student's Signature
________________________________
Date
UNDERGRADUATE STUDENTS: TAKE THIS FORM TO YOUR ADVISING CENTER FOR POSSIBLE APPROVAL OF AN
EXTENSION. If you are moving your graduation term earlier, you do not need to visit your Advising Center.
GRADUATE STUDENTS: TAKE THIS FORM TO YOUR GRADUATE COORDINATOR FOR POSSIBLE APPROVAL OF AN
EXTENSION. If you are moving your graduation term earlier, you do not need to visit your Graduate Coordinator (see reverse for
important information).
Advisor Comments Regarding Approving or Denying the Extension (Please provide comments):
___________________________________________________________________________________________________________
____________________________________________________________________________________________________________
I
APPROVE
DO NOT APPROVE THIS REQUEST
Advisor’s Name (Please Print)
__________________________________
Advisor’s Title
__________________________________________
_________________________
Advisor’s Signature
Date
NOTE: College’s approval of request does not constitute a contract between the student and the University, nor is it an official notification of
remaining degree requirements. It is a permission to extend the student’s graduation term.
This change will typically be processed within 48 hours of receipt of final signatures. Please return this form to the Office of the
Registrar (Admin. 222).
This Completion Date form is being returned unprocessed for the following reason(s):
|___|
You have broken your enrollment by not being registered for three quarters or more. Please contact the Admissions
Office (756-2311).
|___|
You have already registered for the next quarter.
|___|
Wrong form. Please complete a Graduation Application/Request for Graduation Evaluation, available at the Office or the
Registrar or http://registrar.calpoly.edu/sites/registrar/files/forms/ReqUGradEval.pdf, and return the form to the Office of
the Registrar.
|___|
We will not extend your completion term more than four quarters beyond the term you previously reported.
|___|
OTHER
If you have questions, please contact the Evaluations Unit of the Office of the
Registrar, (805)756-2396.
Important reminder for graduate students: All students are required to maintain continuous enrollment
from the time of first enrollment until the completion of their degree regardless of catalog cycle. Students who fail to
fulfill the continuous enrollment requirement will not be permitted to graduate. See the Graduate Education website for
details.
Rev. 5/13/15