Legal name EXACTLY as it should appear on the diploma. (Your name may not exceed 30 letters total).
The student must secure the following signatures before submitting this form to the Registrar.
Please obtain required signatures BEFORE submitting this form to the Registrar.
The student is to keep one copy for personal records and submit original form to the Registrar's Office on or before February 1st of graduating year.
Ecumenical Theological Seminary | 2930 Woodward Avenue, Detroit, MI 48201 | etseminary.edu | 313-831-5200
rev. 10 March 2020
