* - Denotes Required Fields.

*SECTION I: GRADUATION REQUIREMENTS

As a Keiser University student who is approaching completion of my studies, I fully understand that:

1. In order to graduate from Keiser University and participate in commencement exercises, I must meet with
   the Director of Student Services to request participation and to complete an exit interview.
2. All courses and related coursework must be completed satisfactorily; I must maintain at least a 2.0
   GPA.
3. Placement assistance is available to all graduates; in order to receive assistance, I must submit a copy of my résumé (electronic is preferred and assistance is available to help with that) to the Department of
   Student Services.
4. All financial obligations to the College must be met prior to receiving my degree or official
   transcripts.
5. I must obtain clearance signatures from Financial Services, the Bursar, Library, Student Services and Academic Affairs to complete any necessary exit interviews.
6. I must attend a graduation seminar at the beginning of my last semester of classes prior to graduation.
7. I must complete the MAPP (Measure of Academic Proficiency and Progress) test requirement outlined in the University catalog.

*By typing your name you have created an electronic signature as legally binding as your handwritten signature.

*SECTION II: DEGREE AND MAJOR IDENTIFICATION

Please identify the appropriate major by placing a check mark in the box to the left of your major:

SECTION III: COMMENCEMENT INFORMATION

*Identify which month you will complete your last class (or finish your externship):

*Do you plan to participate in commencement exercises for your graduating class?

Yes
No

If yes, please provide the following information so we may provide you with appropriate graduation attire:

Please order a full figure gown
Member of Phi Theta Kappa International Honor Society in good standing
Member of Sigma Beta Delta International Honor Society in good standing

NOTE: Final GPA will be verified with the Registrar’s office to determine appropriate regalia

*Graduation Tickets Requested

*SECTION IV: CURRENT EMPLOYMENT INFORMATION

Please complete for Keiser University records and future employment assistance purposes.

Please note this section must be filled out. If this section does not apply to you then please put N/A in required fields.

Was this position obtained with the assistance of the Department of Student Services?

SECTION V: JOB SEARCH PROFILE
Please answer the following questions so that we may assist you with your job search:

*Do you have reliable transportation?

*Do you have a valid driver’s license?

*Are you legally able to work in the United States?

*What days of the week are you available to work? (Select all that apply)

*What hours of the day are you available to work? (Select all that apply)

*Do you plan to actively job seek immediately upon graduation?

*Have you provided the Department of Student Services with a current copy of your résumé?

*Have you registered to the online career center?

*Are you planning to continue your education upon graduation?

*If yes, have you already applied to a school or schools?

*Have you been accepted yet?

*Please identify the salary you are looking for upon graduation based on research you have done for your field of study and the market in which you will be job seeking:  Minimum: $ per

*What cities are you willing to work in?

*Have you registered with any employment agencies?

*SECTION VI: CONTACT INFORMATION

SECTION VII: PLACEMENT INFORMATION

Please place your signature in the appropriate area:

Placement assistance is a lifetime privilege as a graduate of Keiser University.  Assistance is available at any Keiser University campus.  This includes access to the online career center 24/7, campus career centers, and Department
of Student Services staff to assist you with your résumé, interviewing skills, and notification of job opportunities.

*By typing your name you have created an electronic signature as legally binding as your handwritten signature.

Election for Placement Privileges:

I, , elect to utilize my job placement privileges with the Department of Student Services.  By electing this privilege, I authorize Keiser University to provide prospective employers with information about my academic and attendance record as well as provide verification of graduate status upon request. 
I also authorize Keiser University to verify my employment or continuing education for the purposes of updated
placement records and annual reporting to accreditation agencies.  This waiver supersedes Section 438 of the
General Education Provisions Act (Title IV of Public Law 90-247 as amended), added by Section 513 PL
93-380 (enacted August 21, 1974) as amended by Senate Joint Resolution 40, only for purposes stated in
this paragraph.

Election against Placement Privileges:

I, , elect not to utilize my job placement privileges with the
Department of Student Services for the following reason:

SECTION VIII: PLACEMENT ASSISTANCE SUSPENSION (Optional)

Please provide medical or military documentation to support your request for suspension.

*SECTION IX: STUDENT SERVICES SATISFACTION SURVEY

A primary goal of The Department of Student Services is to grow in our ability to help our students achieve their learning goals.  Responses help us identify our strengths and weaknesses so that we may better serve our students.   Please take a moment to answer the following questions.

Using the rating scale identified below please rate how well you feel the following services enhanced your learning
experience and professional development while attending Keiser University. 

0 = Not Applicable     1 = Not Enhanced       2 = Low Enhancement        3 = Average Enhancement     

4 = Highly Enhanced                           5 = Greatly Enhanced

*Please indicate if there are other services you would like The Department of Student Services to make available.

*Would you be willing to write a brief testimonial as to why you chose Keiser University and how it has helped
you further your career goals?

SECTION X: RELEASE FOR USE OF TESTIMONIAL / PHOTOGRAPH

If you elected YES to provide a testimonial, please sign in the appropriate area below.

I hereby authorize Keiser University, its employees, assignees, or agents to use, reproduce, or distribute my
photograph or photographic likeness, video taped image, and / or testimonial, individually or incorporated into any document(s) having as its (their) function any lawful purpose including but not limited to:

1. Advertising / Promotions
2. Illustration
3. Guidance
4. Description
5. Press Coverage

I understand that I am not entitled to compensation for use of said photographic / video graphic likeness nor
input concerning its use.  I am voluntarily speaking to the press and sharing my story.  As a result, I release
Keiser University from all liability.

*By typing your name you have created an electronic signature as legally binding as your handwritten signature.

SECTION XI: ALUMNI COMMUNICATION CONTACTS

Please assist us in helping you obtain your desired career position.  In the even that we are not able to reach you,
please provide up to five additional contacts so that we can ensure you are notified of any prospective job
opportunities.  You may include friends as well as family members.  The contact information provided will be used for the sole purpose of contacting you about your job search process in the event that your home and / or cellular numbers are no longer correct.  Please make sure to list individuals who will have knowledge of your whereabouts in the event you change numbers or move.

*Please note this section must be filled out. If this section does not apply to you then please put N/A in required fields.

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