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Office of Undergraduate Admissions 833 Montlieu Avenue High Point NC 27262-3598 Phone 800-345-6993 highpoint.edu DEAN S RELEASE FORM FOR TRANSFER STUDENTS Section I This section is to be completed by the applicant. After you have filled out Section I and signed the statement below give this form to the Dean of Students or another appropriate official of the institution* Legal Name Email First Middle Last Permanent Home Address Street City State Zip Telephone Name of College or University Term you plan to enroll at HPU circle one Fall 20 Spring 20 I hereby agree that information concerning my academic and non-academic record may be released to High Point University. Applicant s signature I waive my right to examine this document. I do not waive my right to examine this document. Section II To be completed by the Dean at your current school Has the applicant been disciplined by your institution for academic or social reasons If so please explain on a separate sheet of paper. You are invited to offer your comments and recommendation regarding the applicant s ability to meet the academic requirements and contribute positively to student life at High Point University. Name of official Title Campus telephone Institution Institution address Signature Date Please return this form to. After you have filled out Section I and signed the statement below give this form to the Dean of Students or another appropriate official of the institution* Legal Name Email First Middle Last Permanent Home Address Street City State Zip Telephone Name of College or University Term you plan to enroll at HPU circle one Fall 20 Spring 20 I hereby agree that information concerning my academic and non-academic record may be released to High Point University. Applicant s signature I waive my right to examine this document. I do not waive my right to examine this document. Applicant s signature I waive my right to examine this document. I do not waive my right to examine this document. Section II To be completed by the Dean at your current school Has the applicant been disciplined by your institution for academic or social reasons If so please explain on a separate sheet of paper. Section II To be completed by the Dean at your current school Has the applicant been disciplined by your institution for academic or social reasons If so please explain on a separate sheet of paper. You are invited to offer your comments and recommendation regarding the applicant s ability to meet the academic requirements and contribute positively to student life at High Point University. You are invited to offer your comments and recommendation regarding the applicant s ability to meet the academic requirements and contribute positively to student life at High Point University. Name of official Title Campus telephone Institution Institution address Signature Date Please return this form to. After you have filled out Section I and signed the statement below give this form to the Dean of Students or another appropriate official of the institution* Legal Name Email First Middle Last Permanent Home Address Street City State Zip Telephone Name of College or University Term you plan to enroll at HPU circle one Fall 20 Spring 20 I hereby agree that information concerning my academic and non-academic record may be released to High Point University. Applicant s signature I waive my right to examine this document. I do not waive my right to examine this document. Section II To be completed by the Dean at your current school Has the applicant been disciplined by your institution for academic or social reasons If so please explain on a separate sheet of paper. .

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