Request for Letter of Good Standing

Please list the name of Person(s) or Institution(s) to whom your letter should be addressed (i.e. Dear Jane Doe, Office of Admissions etc.)

Records, documentation, and information may be released to person(s), institution(s) below.

This form is used to determine if an applicant has any current academic or disciplinary sanctions on their record to fulfill a request for

letter of good standing. Allow 5 to 10 business days from receipt of request for processing. Before submitting a letter of good standing,

OUE must verify your identity. A request sent through a student’s Emory e‐mail account will not require additional verification.

• Students who present the request in person should show an Emory ID or other official form of photo identification.

• Alumni who submit this form via e‐mail should include a copy of a photo identification with the request. Return to: Office for

Undergraduate Education, Candler Library, 550 Asbury Circle, Suite 200 Atlanta, GA 30322; Mailstop: 1580‐002‐2AA

• If you are in need of a Dean’s Certification for an application to law school, medical school, or other programs in the health

professions (dental school, veterinary school, etc.), please contact oue.records@emory.edu.

− For Domestic Transient Study, the Letter of Good Standing is completed through the application process. Please do not use this form.

‐ Students in need of Enrollment Verification for financial lenders, jury duty, insurance, etc. must contact the Office of the University

Registrar

Student Information (Please Print)

Student Name:

Emory ID:

Email Address:

Mobile Phone:

Please Carefully Read This Section Before Signing

I hereby consent to the release by Emory College of Arts & Sciences of any and all records, documentation, and information regarding my academic

and disciplinary record to the person(s) or institution(s) specified below. This consent permits release of records, documentation, and information by

any means including but not limited to furnishing copies of documents and summarizing information whether contained in documents or not,

including discussing facts and circumstances surrounding any academic probation or exclusion and any instance in which I was alleged or found to have

violated the Honor Code. I further consent that the Office for Undergraduate Education may review the academic and disciplinary records of other

academic units and student disciplinary offices at Emory University in order to verify my academic and disciplinary record. The Office for

Undergraduate Education may refer this request to other academic units and disciplinary offices to complete the letter of good standing request. I

understand that the consent will remain in effect until the Office for Undergraduate Education receives my written and signed revocation of the

consent. I release Emory University and its employees, including faculty, staff and administrators, and its trustees, officers, agents, and students from

all liability in releasing records, documentation, and information covered by this consent.

Signature: Date:

Please provide the information below

This information will be used for the heading of your letter.(i.e. address of school, institution etc. Do not enter your own address)

Mailing Address:

Street

City

State

Zip Code

Fax Number or Email:

Special Instructions:

Delivery Instructions

(Select One):

 Email to student requestor  Mail to address above

 Email to Person or Institution listed on this form

 Fax  Hold for pick up

Reason or Purpose (Select One):

 Background Check

 Military

 Employment

 Internship

 Graduate School

 Other (list here):

 Study at another institution (non‐Emory credit)

PLEASE NOTE: The Office of the University Registrar requires a copy of your official transcript. Onc e the coursework is complete, you must request the host institution

send an official transcript to the following postal or email address:

Office of the University Registrar

Attention: HOPE/CHECSCoordinator

201 Dowman Drive

Suite 100

Atlanta, GA 30322

Or:

registr@emory.edu

(for electronic transmission)

Attention: HOPE/CHECS Coordinator

Revised 7/1/24/YT