Date:(mm/dd/yyyy)
         

Email Address:
         

Student Number:
         

Full Name: [last, first middle]
         

Print Full Name exactly as you wish it to appear on your diploma - LEGAL NAME ONLY
*If your name is different than that given at the time of your first registration, legal evidence of the change, except marriage, must be presented to warrant change of diploma.

Sex:
      Male Female

Marital Status:
          Single Married

Denver Address:
          Street:
          City:     State: Zip:
          Phone:

Permanent Home Address (Street, City, State and Zipcode)
          Street:
          City:     State: Zip:

Month and Year of Intended Graduation:
         

Degree:
          - Please Select One - Bachelor of Arts

Major (1):
         
Major (2):
         
Minor (1):
         
Minor (2):
         
Minor (3):
         

Concurrent Degree Program *(If Applicable):
         
*Please Note-A separate application must be submitted for each degree. Applications for graduate degrees must be submitted to the corresponding graduate unit.

Alumni Record

If married (female) give name of spouse
         

If married (male) give maiden name of spouse
         

Has (he/she) attended DU?
          Yes No

If Yes -
          Dates     College     Degrees

Occupation after graduation
         

Degrees from other Colleges
          Date

List DU organization membership, offices held and honors awarded