This application is for students completing an advanced certificate program to receive their certificate. The student must submit this application to the registrar's office. Upon verification of completion of the certificate program requirements, including minimum credits and GPA, the student will be awarded a New York State certified certificate, though they are not awarded at commencement with degree recipients. The application collects the student's name, contact information, certificate program and track if applicable, intended date of completion, demographic information, and requires the student's signature.

1. Registrar
ADVANCED CERTIFICATE COMPLETION
APPLICATION
This application is only applicable to students who are enrolled in one of the Graduate Advanced
Certificate Programs. Upon completion of the certificate program, it is the students’ responsibility to
submit this application in order to receive a certificate. Students will be awarded a New York State
certified certificate. NOTE: Advanced Certificate recipients are NOT awarded at commencement.
Completed By Student
Print name exactly as it is appears on the certificate. The name must be the same as on Registrar’s
record unless legally changed. Please print neatly.
□ Mr. □ Ms. □ Mrs. □ Other _________ Student ID: _______ – ______ – ___________
First Name: ____________________________ Middle Name/Initial: ________________
Last Name: _____________________________________________________________
Telephone: (________)____________________ Email Address: ___________________
Address: ______________________________________________________________
City: _______________________ State: __________ Zip: _______________
MA Program (if applicable): _________________________________________________
Certificate Information: What certificate are you applying for? (check one only):
□ Advanced Certificate in Crime Prevention and Analysis (446)
□ Advanced Certificate in Terrorism Studies (448)
□ Advanced Certificate in Forensic Accounting (447)
□ Advanced Certificate in Applied Digital Forensic Science Program (449)
□ Advanced Certificate in Computer Science for Digital Forensics Program (444)
□ Postgraduate Certificate in Forensic Psychology (445) List Track: ______________________
I am applying for degree date (check one only): □ August □ February □ June Year: _____
Which category best describes you? (This is for college statistical purposes only.)
□ Black – Non-Hispanic □ White – Non-Hispanic □ Hispanic/ Latin American
□ American Indian/ Alaskan □ Asian/ Pacific Islands □ Other ____________________
Student Signature (required): ___________________________ Date: ___________
For Office Use Only
Ineligible: ______ Reason: ________________________________________________
Eligible: ______
Total Credits: __________ Cum. GPA: __________ Minimum Residency Credit: ______
Reviewed By: _____________________________________ Date: _________________
For Office Use Only
Fall _____ Winter _____ Spring _____ Summer _____
Rec’d By: _______________________ Date Rec’d: __________________
White – Registrar Yellow -- Student 11/2/2015