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: Ofce 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 Prot 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
Certicate (non-licensure)
Post-Baccalaureate
Initial Teacher Licensure
Post-Masters Nursing Cert.