Webster University
North Florida Region
Graduation Form

Please fill out all of the requested information.
Fields that have a gray background are required.

Graduate Name and Contact Info

Please type your name as you would like it to appear on the graduation program. Middle names or middle initials will not be used on the program. Please note that this will not affect how your name appears on your diploma. Your diploma will have your name as you requested on the Petition to Graduate form.
 
First Name:   
Last Name:   
Home Phone:   
E-mail Address:   

 


RSVP and Guest Count

Will you be attending the graduation ceremony?  YES NO


Total number of guests expected to attend:
(Due to the size of Jacoby Hall, graduates should feel free to invite all those wishing to attend. However, the number of seats specified will determine the number of seats available for guests.)

 

Request for Certificates of Recognition

Please indicate the number of certificates of recognition you would like. These certificates are free and make a nice presentation as mementos to friends, family, and co-workers who were supportive of your academic efforts. Please request only the amount that you intend to use, up to 15.mount that you intend to use. 

 
(Limit of 15)

 


Military Info
Are you active duty military?  Yes No
If so, please indicate your command:
Are you retired military? Yes No
If so, please indicate your command and date of retirement:
Command:  
Retirement Date: