Advanced-Certificate-Completion-Application
- 1. Registrar ADVANCED CERTIFICATE COMPLETION APPLICATION This application is only applicable to students who are enrolled in one of the Graduate Advanced Certificate Programs. Upon completion of the certificate program, it is the students’ responsibility to submit this application in order to receive a certificate. Students will be awarded a New York State certified certificate. NOTE: Advanced Certificate recipients are NOT awarded at commencement. Completed By Student Print name exactly as it is appears on the certificate. The name must be the same as on Registrar’s record unless legally changed. Please print neatly. □ Mr. □ Ms. □ Mrs. □ Other _________ Student ID: _______ – ______ – ___________ First Name: ____________________________ Middle Name/Initial: ________________ Last Name: _____________________________________________________________ Telephone: (________)____________________ Email Address: ___________________ Address: ______________________________________________________________ City: _______________________ State: __________ Zip: _______________ MA Program (if applicable): _________________________________________________ Certificate Information: What certificate are you applying for? (check one only): □ Advanced Certificate in Crime Prevention and Analysis (446) □ Advanced Certificate in Terrorism Studies (448) □ Advanced Certificate in Forensic Accounting (447) □ Advanced Certificate in Applied Digital Forensic Science Program (449) □ Advanced Certificate in Computer Science for Digital Forensics Program (444) □ Postgraduate Certificate in Forensic Psychology (445) List Track: ______________________ I am applying for degree date (check one only): □ August □ February □ June Year: _____ Which category best describes you? (This is for college statistical purposes only.) □ Black – Non-Hispanic □ White – Non-Hispanic □ Hispanic/ Latin American □ American Indian/ Alaskan □ Asian/ Pacific Islands □ Other ____________________ Student Signature (required): ___________________________ Date: ___________ For Office Use Only Ineligible: ______ Reason: ________________________________________________ Eligible: ______ Total Credits: __________ Cum. GPA: __________ Minimum Residency Credit: ______ Reviewed By: _____________________________________ Date: _________________ For Office Use Only Fall _____ Winter _____ Spring _____ Summer _____ Rec’d By: _______________________ Date Rec’d: __________________ White – Registrar Yellow -- Student 11/2/2015