Graduate Certificate Enrollment Form

Home
Admission & Aid
Graduate Admission
Graduate Certificate Enrollment Form

Congrats on your acceptance to Lebanon Valley College. Please complete and submit the following enrollment form.

Biographical/Contact Information

Full Name

First

Last

Preferred first name (if different from above):

Pronouns

Preferred first name and pronouns will be made available internally (such as campus directory, and class rosters) and will not replace students’ legal name, where required. The College reserves the right to deny a preferred name and pronoun if it is used inappropriately.

Program Information

I intent to

Accept the offer of admission
Decline the offer of admission

If declining the offer of admissions:

Please share why you have decided not to attend Lebanon Valley College; please indicate if you have chosen another College/University.

If accepting the offer of admissions:

If applicable, professional personal ID (Required for ACT 48 credits)

Anticipated start date (please list month and year):

Anticipated graduation date (please list month and year):

How many credits do you plan to enroll in each term?

Do you plan to continue on for a master's after earning the certificate?