Please fill out this online form, print, sign, and present to the individual making the recommendation.
Please fill out this online form, print, sign and present to the individual making the recommendation.
For the purpose of:
I consent to the release of any information from my education record (e.g. grades, GPA) that is deemed appropriate for purposes of the recommendation or evaluation.
Please review your entries on this form. If all information is entered correctly, please print, sign, and present it to the individual making the recommendation.
Student Signature: _________________________________________________
Student Signature: _______________________________________ Date: __________________________
Is a disciplinary review required?
Connect with the Office of the University Registrar
Office of the University Registrar 112 Shields Building University Park PA 16802
Privacy | Nondiscrimination | Equal Opportunity | Accessibility | Copyright
The Office of the University Registrar is committed to making its websites accessible to all users. Please send comments or suggestions about making accessibility improvements to firstname.lastname@example.org.
The Pennsylvania State University © 2022