Senior Year Information and Declaration Form

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Legal First Name *

Preferred First Name *

Last Name *

Street Address * 🛈

Address Line 2

City *

State *

Zip Code *

Student Phone Number *

Student District 11 Email *

Student PPSC Email *

Student Personal Email Address (Do not use your D11 or PPSC email address here.) *

Parent/Guardian Names *

Parent Email Address 1 *

Parent Email Address 2

Date * +

Preferred name declaration and information

On awards and During award ceremonies. *

Legal name, or I do not have a preferred name different than my legal name.

Preferred name.

In the yearbook. *

Legal name, or I do not have a preferred name different than my legal name.

Preferred name.

On my diploma. *

Legal name, or I do not have a preferred name different than my legal name.

Preferred name.

During the graduation ceremony. *

Legal name, or I do not have a preferred name different than my legal name.

Preferred name.

Important Dates to put into your calendar.

To receive your associate degree whether or not you plan to attend Pikes Peak State College's graduation ceremony, you MUST complete the PPSC Graduation Application. You can do that by clicking the link below, or navigating to PPSC's website > admissions > Registrar & Records > Graduation (In the brown links below the heading.)

Deadlines to Apply for Pikes Peak State College Graduation are:

July 15th for Summer semester
November 15th for Fall semester
March 15th for Spring semester

Apply for PPSC Graduation

You can submit a Senior/Graduation Photo for the slideshow at graduation and the yearbook here.

INFORMATIONAL: Senior photos for the yearbook are due no later than December 1st. If you didn't upload one here, you can email them to Kristine.Stenger@d11.org and Angela.Banfield@d11.org.
For the graduation slideshow, you can change your photo until May 1st by emailing a new photo to Kristine.Stenger@d11.org.

Signatures and Attachments

My signature below indicates that I understand the following: (You must check all boxes.) *

This form MUST be received by Odyssey ECCO no later than September15th for your senior year.

Should this form NOT be received by that date, Odyssey ECCO will use your legal name in all situations.

This decision is final, and we will not be making any changes after the due date of this form.

Print Student's full name *

Student Signature (Required) *

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Parent/Guardian's full name *

Parent Email address in which a link to this form will be emailed for signature: *

Parent Signature (Required)

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