Admissions Interview Report Waiver Request Form
Submit your request to waive the receipt or disclosure of an admissions interview report. Please complete all required fields accurately.
Applicant Full Name
*
First Name
Last Name
Applicant Email Address
*
example@example.com
Applicant Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Institution Name
*
Program or Department
*
Admissions Interview Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Waiver Request
*
Waive receipt of interview report
Waive disclosure of interview report
Waive both receipt and disclosure
Preferred Delivery Method (if applicable)
Please Select
Email
Postal Mail
No delivery required
Reason for Waiver Request
*
Declaration and Acknowledgment: I confirm that I am requesting this waiver voluntarily and understand the implications of waiving my right to receive or disclose the admissions interview report.
*
I acknowledge and accept
Submit Waiver Request
Should be Empty: