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Free PennState Alternate Commencement Site Form – Associate - PDF Form Download

PennState Alternate Commencement Site Form - Associate Overall rating: ☆☆☆☆☆ 0 based on 0 reviews
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Permission to attend commencement exercises at a location other than the Penn State Campus where you completed your
academic work may be requested by completing this form.

PennState Request for Alternative Commencement Site


Text Version of this Form

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Request for Alternative Commencement Site
(Form O-2 Undergraduate Associate Students Only)

Permission to attend commencement exercises at a location other than the Penn State Campus where you completed your
academic work may be requested by completing this form. Please follow the instructions below.

1. Forward this form to the Graduation Coordinator in the Dean’s Office in the College of your major no later than the end of the
eleventh week of the semester you are graduating. Your request will be forwarded to the Graduation Coordinator in the Dean’s
Office of the alternative site College for their approval. The alternative site College being asked to consider this request
reserves the right to approve or deny your request.

2. If approval is granted, the Graduation Coordinator in the Dean’s Office of the alternative site College will notify
you of the approval. The alternative site College will also provide you with instructions concerning the
commencement ceremony.

3. If the request to graduate at an alternative site is not approved, the Graduation Coordinator in the College Dean’s Office
denying the request will notify you and the other College of the denial.

I request permission to attend commencement exercises at the “Requested Commencement Location” indicated below. I
understand that the awarding of the diploma is contingent upon the satisfactory completion of all graduation requirements, as
certified by the appropriate faculty within my College.

Student Name: ________________________ PSU ID: ________________________

Degree Expected: _________________________ Major: _____________________________

Semester of Graduation: _________________________ College: _________________________

Assigned Commencement Location: _____________________________________

Requested Commencement Location: ____________________________________ (If University Park Campus, must specify College)

Reasons(s) for Request: _______________________________________________________________________

Student Contact Information:
Local Street address: _______________________________________________________
City: __________________________State: _____________________ Zip: __________
Phone: _______________________________ Email: ___________________________

Student Signature: ______________________________________ Date: _______________

Degree-Granting College Review: Signature: __________________________Date:__________

Alternative Site Approval: Signature: __________________________ Date:__________ □ Approved □ Denied

Note to Colleges:

If approved, the alternative site College will notify the student of the approval and update ISIS screen ARUGX.

If denied, the College denying the request will notify the student of the denial.

Approved: ACUE (5-5-05)
Revised: Editorial (1-17-12)
Revised: Editorial (2-16-12)

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