Canisius Transfer Recommendation Form
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1
2tranSFer
reCOMMenDatIOn FOrM
Part One
To be Completed by Applicant and Submitted to Your Current College
Please submit this form to the dean of students or other appropriate official at the college or university you are currently attending. Please
note that this form is NOT an academic reference and must be given to the college official charged with maintenance of disciplinary records.
If you are not currently enrolled in a college or university, please have this form completed by the appropriate official at the college or university
last attended.
LAST NAME
FIRST NAME
MIDDLE INITIAL
MAIDEN NAME
MALE
FEMALE
PREFERRED FIRST NAME
DATE OF BIRTH (MM/DD/YYYY)
GENDER
SOCIAL SECURITY NUMBER
†
PERMANENT HOME MAILING ADDRESS
CITY
STATE
ZIP
PHONE NUMBER
CELL PHONE NUMBER
E-MAIL ADDRESS
STUDENT’S SIGNATURE
DATE
A TRANSFER APPLICATION wILL BE CONSIDERED INCOMPLETE wITHOUT THIS FORM.
See reverSe Side for Part two.
† OPTIONAL
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Parent category: Letters