Fillable 5151 State University Drive, Los Angeles, California 90032-8534 (California State University, Los Angeles)

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5151 State University Drive, Los Angeles, California 90032-8534 (California State University, Los Angeles)

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California State University, Los Angeles
5151 State University Drive, Los Angeles, California 90032-8534
Human Resources Management
Date:
California State University, Los Angeles
Employment Services Unit
5151 State University Drive, Admin. 606
Los Angeles, CA 90032
Attention: Registrar’s Office/Records
is an applicant for employment at California State University, Los
Angeles, and has listed your institution as his/her alma mater.
We would appreciate your supplying/verifying the following information pertaining to his/her
graduation from your institution.
Name (while in attendance):
Date of Graduation: Degree Received:
Major: Minor:
Grade Point Average:
Date of Graduation: Degree Received:
Major: Minor:
Grade Point Average:
Signature for your University: Date:
Title:
I, ______________ hereby authorize the university/person to whom this letter is addressed to furnish
California State University, Los Angeles, with the above requested information. Furthermore, I release
said institution or person from any and all liability incurred in furnishing such information.
Applicant’s Signature: Date:
Social Security Number: Date of Birth:
PLEASE RETURN TO HUMAN RESOURCES MANAGEMENT, ADMIN. BLDG. ROOM 606.
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5151 State University Drive, Los Angeles, California 90032-8534 (California State University, Los Angeles)

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Completed 22 July 2020

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