Has not applied
Has not applied
Graduation
Degree(s) conferred: Year(s) of graduation: ________
Upcoming graduation:
Upon successful completion
Has applied
Completed requirements (formal confirmation from the
Faculty required, minimum 2 weeks processing)
Has applied
Letter for Post-Graduate Work Permit
Y M D
Full-time
Part-time
Undergraduate
Graduate
*requiredinfo
Student #
*Name: _________________________________________
First Middle Surname
*Phone: (____) ________________ *DOB:_____/____/____
*Email: _________________________
Faculty:
Please Print
Date____________________________
Student Authorization
I certify that I am the student as stated. The information pro-
vided is true and correct in all respects. I hereby authorize
The University of Western Ontario to release Official West-
ern Letters as indicated.
X ________________________________________________
Student Signature (digital signatures are not accepted)
The following services are additional to the Official Western Letter fee:
Mastercard
Cardholder’s Name as it appears on card _____________________________ Cardholder’s Signature _______________________________________
Please note: It is at the discretion of Student Central staff whether an
Official Western Letter can be processed immediately. Negative service
indicators on a student’s academic records will prevent the release of
Official Western Letters.
Advance Standing/Transfer Credits
Extra courses (e.g. QECO)
2 weeks processing time
RNAO fees letter
Fees for Multiple Terms:________________________
Registration for Multiple Terms:__________________
OFFICE USE ONLY
Staff Initials ________ Date __________
W Drive Peoplesoft Letter Loc
_____#oflettersx$16=
addcourierfee(ifapplicable)
addĞ>ĞƚƚĞƌĨee(if applicable)
TotalAmountPayable
OFFICIAL WESTERN LETTER
REQUEST FORM
Fax (519) 850-2397
# of copies
.
Other Delivery Methods: Complete Sections Below
Hold for pickup
(Required if courier service selected)
Attn: ____________________________________________
Address: _________________________________________
________________________________________________
City: _____________ Prov:_____ Postal Code:___________
Telephone #: (_____) __________________________
eLetter (add $6.00)
Email Address:
Exp. Date:
Credit Card #
LETTERS AVAILABLE FOR IMMEDIATE
PROCESSING **
**These letters can also be ordered via Fax or Mail and will be
processed within 4 to 5 business days.
Current Term OR Past Term _______________
Intent to Register for next term
RESP Letter
Fees Paid (Main Campus Only)
Enrollment for Single Term
Letter contents: Start/end dates, faculty, full/part time status
Intent to Register for next term
Letter for Visa Purposes (Main Campus Only)
Letter contents: Registration, start and end dates, fees paid,
full/part time status, faculty, year enrolled and program length.
Indicate Term Required ___________________
OTHER AVAILABLE LETTERS
(4-5 BUSINESS DAYS TO PROCESS)
FEES: Official Western Letter - $16.00/copy (includes the cost of regular mail). All fees payable at time of request & are subject to change.
(digital signatures are not accepted)
eLetter: $6.00
Courier: $25 within Ontario $34 remainder of Canada
(additional charges may apply for return shipments)
(must be picked up within
6 months of ordering)
$48.00 USA $77.00 International
