Release Authorization Page 5
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13ACADEMIC RECOMMENDATION
Release Authorization
Your application will be held until we receive this form.
RELEASE AUTHORIZATION
To Be Completed by Student
________________________________________________________ ____________
Student Signature
Date
______________________________________________________________________
Student Name
_______________________________________________________________________________
Address
t /
y /
e / ZIP)
STUDENT RECOMMENDATION
To Be Completed by Principal or College Registrar
________________________________________________________ ___________
Principal or College Registrar’s Signature
Date
_____________________________________________________________________
Principal or College Registrar’s Name
______________________________________________________________________________
Address
t /
y /
e / ZIP)
(
)
_________________________________
Telephone No.
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