Qualtrics Survey | Qualtrics Experience Management

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Name

Cohort
PG students must make requests through their Business Managers.

D1
D2
D3
D4
AS2
AS3
AS4
PhD
MS Only
Graduated Alumni - must include year of graduation

Type of Letter/Form (e.g. verification, scholarship, jury duty, achievement, class rank/GPA, PASS Dean recommendation)

Regarding transcripts: These requests need to be made by the student with the Office of the Registrar directly. The Office of Academic Affairs is not able to provide transcripts or process requests for transcripts.

Please select all that should be included in the letter

Confirmation of Good Standing
Confirmation of Graduation Date
Confirmation of Full-time Status
Hours engaged in classes/clinic
Other

What is the OFFICIAL deadline for your request?

Please avoid submitting "ASAP" as this does not allow our team to efficiently priorize letters.

Please specifically list the requesting party/individual/organization:

Email of the requesting party/individual/organization:
If you are the recipient, then provide the email address you wish to receive

How does the requesting party wish to receive the letter?

Email
Postal Mail
Myself (the student) sending a copy
Other

Do you (the student) require a copy?

Yes, email copy
Yes, paper (hard) copy
No

Any supplemental information necessary to generate request (jury duty notice, state dentistry examining board applicant form, etc...)? If so, please upload here:

Any other required information? (This includes any important deadlines!)