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To graduate, please complete and submit this form by April 1, 2024

Full Name (First, Middle and Last Name)

Name Format on Parchment


Phone Number *

Date of Birth *

Street Address *

City, Province, Country, Postal Code *

Program of Studies

Public Acknowledgement at Graduation

Courtesy Checklist

The personal information collected on this form and in your student record will be used for the purpose of processing your request for Parchment/Convocation. Your name may be published in the Convocation Program with information on the program of studies you have successfully completed. The details made public at Convocation may also include any academic honours you have been awarded. 

Names of students graduating from various programs and the academic honours students have been awarded may also be released to the media or be included in other publications. Certain personal information will be released to the Genesis Institute of Theology, Evangelism and Leadership's Alumni Office. This information collected is protected by the provisions of the Alberta Freedom of Information and Protection of Privacy Act and the Statistics Canada Act. If you have any questions about the collection and use of this information, contact administration at

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