University at Buffalo

Application for Degree

List your name as you wish it to appear on your diploma:


(first, middle, last)

NOTE: If this name is different from that on your records, you will be requested to document a name change.

Student Identifier Number:


(SSN or Student ID #)

Gender:

Male Female

Address and phone where evaluator may reach you:

Address:

(street, city, state, zipcode)

Phone:

Date requested for Degree Conferral:

February 1, 1996
June 1, 1996
September 1, 1996

Address to which diploma should be sent:

Same as above address Different address

(street, city, state, zipcode) (approx. 6-8 weeks after conferral)

Intended Degree:

Major Field:

Minor Field:


Authentication

Username:

Password:

rastrl@acsu.buffalo.edu