If you are completing an initial teacher licensure program, please check here:
COMPREHENSIVE EXAM WILL BE TAKEN ON: _______________
(For English, History, Spanish Graduate Students Only)
CHES EXAM WILL BE TAKEN ON: ____________________________
(For Health Education Graduate Students Only)
ASHA EXAM WILL BE TAKEN ON: _____________________________
(For SLP Graduate Students Only)
PRAXIS II EXAM WILL BE TAKEN ON: _________________________
(For School Psychology Graduate Students Only)
I intend to complete my degree requirements in:
MAY AUGUST DECEMBER of YEAR: _________
INTENT TO GRADUATE FORM
DEADLINE FOR FILING:
March 15 for May
June 15 for August
October 15 for December
Method of Payment
Account Number Expiration Date 3 or 4 digit security code
Check MasterCard Visa Discover American Express
Cardholder’s Name
(print) ____________________________________________Cardholder’s Signature ________________________________________________
GRADUATE STUDENTS at Worcester State University must le the Intent to Graduate Form for the semester in which
all course requirements, including the Comprehensive Examination or CHES Examination, will be completed.
A graduation fee of $15.00 must accompany this form and be returned to: Ofce of Graduate & Continuing Education
(
The $15.00 graduation fee will be waived for Post-Baccalaureate students)
486 Chandler Street
Worcester, MA 01602
STUDENT NAME: ________________________________________________________________________
Please print your name exactly as you would like it to appear on your diploma and in the commencement program.
STUDENT I.D. #: _______________________
ADDRESS: _______________________________________________________________________________
__________________________________________________________________________________________
Check One:
Biotechnology
Curriculum & Instruction
Early Childhood
Elementary
English
English as a Second Language
Health
Health Care Administration
History
Management
Middle School
Moderate Disabilities
Non Prot Management
Nursing: Community & Public Health
Nursing: Nurse Educator
Reading
Secondary
School Leadership and Admin.
School Psychology
Spanish
Speech Language Pathology
DEGREE:
Education Specialist (EdS.)
Master of Arts
Master of Education
Master of Occupational Therapy
Master of Science
Post-Baccalaureate
Certicate (non-licensure)
Post-Baccalaureate
Initial Teacher Licensure
Post-Masters Nursing Cert.