Application for Degree Form

	Sam Houston State University
	A Member of The Texas State University System Office of the Registrar Box 2029 Huntsville, Texas 77341-2029	Office: (936) 294-1035 FAX: (936) 294-4964

Diploma Fee -- $25.00 (Additional $25 Late Fee Assessed If Filed After Application Deadline)
NOTE: Receipt available upon request

APPLICATION FOR DEGREE

NOTE *** A copy of your Official Degree/Study Plan must be on file in the Registrar's Office before your Application for Degree can be accepted.

___________________________________________________________________
First	Middle	Last

The name to appear on the commencement program and diploma will be the official name listed on your academic record with Sam Houston State University.

Sam ID Number _____________________ or Social Security Number_______________________

Degree Expected: (Circle the one desired)

B.A., B.S., B.B.A., B.M., B.F.A., B.A.A.S.,

M.A., M.Ed., M.B.A., M.F.A., M.L.S., M.M., MPA, M.S., S.S.P, Ph.D., Ed.D.

Major __________________________	Minor __________________________
Graduation Date _______________________	Date Applied ___________________

Home Address

(Street or P.O. Box)

(Town)

(State)

(Zip)

Tuition Rebate for Baccalaureate Candidates,
see if you qualify.

Local Phone No. _______________________

Permanent Home Phone No. __________________________

Huntsville Address ______________________________________________________________________

**We accept check, cash, money orders, Visa, Mastercard only.

Circle: VISA / MASTERCARD / AMERICAN EXPRESS
Card Number: ______________________________
Expiration Date: _____________________________
Signature: __________________________________

Dear Degree Applicant:

The 75^th Texas Legislature created several new performance measures for institutions of higher education. One of the performance measure Sam Houston State University must submit to the Legislative Budget Board is the percentage of graduating baccalaureate students whose parents did not attend college. Parents are defined only as birth parents, adoptive parents, or legal guardians.

Please respond to the question below and return the bottom portion of this letter to the Office of the Registrar, Box 2029, Huntsville, TX 77341.

Your assistance will be greatly appreciated.

Sincerely,

Teresa Ringo
Interim University Registrar

Return to:

Office of the Registrar

Box 2029

Huntsville TX 77341-2029

Did either of your parents (or legal guardians) attend college? YES NO
Your Name: __________________________________________________
Your Sam ID Number or Social Security Number: _____________________________________
Your Date of Graduation: ________________________________________

Thank You!

******Note: This does not change your graduation date. You must notify our office at (936)294-1033, if you wish to change your date of graduation.