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Graduate Certificate Course Verification

Use this form if you earning a Graduate Certificate to verify that you have completed the coursework necessary to receive the certificate.


  1. Fill out all fields, using the spaces provided to list all coursework that fulfills the requirements for the certificate. If you have more courses than there are available spaces, please type your courses on a separate document and attach it to this form.
  2. Print the form and sign where indicated.
  3. Obtain the name and signature of the Certificate Program Coordinator for your program.
  4. Submit the completed form to the Graduate School for processing in one of the following ways:
    • Scan the signed form and email it to
    • Send the form by mail to the Graduate School.
    • Deliver the form in person to the Graduate School main office.

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