Return this form to the Office of the Registrar 633 Clark St. Evanston, IL 60208

PETITION TO GRADUATE - Additional Majors/Minors/Certificates

Winter Spring Summer Year: __________

Student Signature: ____________________________________________________________________ Date: ______________________

First Name Middle Name Last Name Student ID Number

I plan to graduate in: Fall

Please use reverse side of this form for adviser-approved substitutions, waivers, or related course approvals.

Page 1

with a Bachelor of:

Northwestern Email AddressSchool:

Suffix

Are you dropping any non-McCormick Majors/Minors/Certificates?If so, please list them here:

||||

Use this form if you have already turned in your petition to graduate or if you are a McCormick student with a major, minor, or certificate outside ofThe McCormick School of Engineering and Applied Science.

| | | |

Additional non-McCormick Majors/Minors/Certificates *Dual Bachelor's Degree Students must submit a separate petition for their second degree.

Please confirm your degree progress and additional non-McCormick major/minor/certificate requirements using the Degree Progress Report in CAESAR.

Major Minor Certificate: __________________________________________________________ Requirement year: __________

Concentration (if applicable): ____________________________________________________

Adviser Name:_______________________________ Adviser Signature: _______________________________ Date: __________

Major Minor Certificate: _________________________________________________________ Requirement year: ___________

Concentration (if applicable): ____________________________________________________

Adviser Name:_______________________________ Adviser Signature: _______________________________ Date: __________

Return this form to the Office of the Registrar 633 Clark St. Evanston, IL 60208Page 2

For Major/Minor/Certificate:_____________________________________________________________

Adviser Approvals:

For Major/Minor/Certificate:_____________________________________________________________

Adviser Approvals:

For Major/Minor/Certificate:_____________________________________________________________

Adviser Approvals: ||||

Adviser Initials:_________

Adviser Initials:_________

Adviser Initials:_________

Please indicate substitutions, waivers, and related course approvals to be made to the Degree Progress Report in CAESAR. *Please also include any necessary major or minor worksheets.

Student ID Number

PETITION TO GRADUATE - Additional Major/Minor/CertificateAdviser Approvals

| | | |

First Name Middle Name Last Name Suffix