Black Graduation Spring 2025 Application Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required)CSUN Email Address(Required) Student ID(Required)Degree Type(Required)DoctorateMaster'sBaccalaureateMajor(Required)Second MajorMinorApplication Fee $65.00 – This fee covers your participation fee, congratulatory gift, and (1) program booklet.(Required) I’m confirming the application fee has been paid. I will pay the application fee before the deadline of May 9, 2025. Please visit the Associate Students Ticket Office to remit this application and participation fee. Credit Card, Debit Card or Cash is accepted. 18111 Nordhoff Street Northridge, CA 91330-8325 Telephone: 818-677-2488 Hours of Operation: 10:00am – 6:00pm (M-Sa) Profile and Participation Fee are due on or before May 9, 2025! For Alternative payment, please contact the Black Graduation committee at blackgraduation@csun.edu.By signing this document, I _________________________, agree to the following in participating in the California State University, Northridge Black Graduation Celebration: 1. I will hold the utmost respect for faculty, staff, and volunteers during the graduation ceremony. 2. I will inform my family and friends to conduct themselves in a positive manner during the graduation ceremony. 3. I will remain seated during the graduation until my name is called and return to my seat after my name is called for the duration of the graduation ceremony. 4. I will inform my friends and family that there will be a picture section for them to take pictures during the graduation ceremony. 5. I will inform my friends and family that they are to respect other graduates during the ceremony by returning to their seats after I have received my certificate. (This is if family and friends are blocking the view of others in the picture section.) 6. I will be respectful of other graduates by waiting until the graduation ceremony is ANNOUNCED “over”, to return to my family for pictures, hugs and kisses, conversing… etc… 7. REFUND POLICY: Due to University and logistical expenses, refunds will not be provided, except for extenuating circumstances that will be at the discretion of the University Staff Committee. Please contact blackgraduation@csun.edu to submit an appeal for review.(Required) By clicking this box, I consent to the following:By signing this document, I _________________________, agree to the following in participating in the California State University, Northridge Black Graduation Celebration: 1. I will hold the utmost respect for faculty, staff, and volunteers during the graduation ceremony. 2. I will inform my family and friends to conduct themselves in a positive manner during the graduation ceremony. 3. I will remain seated during the graduation until my name is called and return to my seat after my name is called for the duration of the graduation ceremony. 4. I will inform my friends and family that there will be a picture section for them to take pictures during the graduation ceremony. 5. I will inform my friends and family that they are to respect other graduates during the ceremony by returning to their seats after I have received my certificate. (This is if family and friends are blocking the view of others in the picture section.) 6. I will be respectful of other graduates by waiting until the graduation ceremony is ANNOUNCED “over”, to return to my family for pictures, hugs and kisses, conversing… etc… 7. REFUND POLICY: Due to University and logistical expenses, refunds will not be provided, except for extenuating circumstances that will be at the discretion of the University Staff Committee. Please contact blackgraduation@csun.edu to submit an appeal for review.