Fillable Transfer Recommendaon Form (Daemen College)

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Transfer Recommendaon Form (Daemen College)

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Part One: TO BE COMPLETED BY STUDENT
Please complete and sign the top secon of this form and submit to the Dean of Students of the most recent college aended.
Name____________________________________________________________________________________________
Permanent Address_________________________________________________________________________________
Home Phone_____________________________________ Cell Phone _______________________________________
I hereby authorize and request the Dean of Students to release to Daemen College all the informaon requested by the
aforesaid pertaining to my record.
Signature of Applicant __________________________________________________ Date________________________
School to which you are subming this form_____________________________________________________________
Part Two: TO BE COMPLETED BY DEAN OF STUDENTS AT LAST COLLEGE ATTENDED
The above applicant has applied for admission as a transfer student to Daemen College. Please complete the secon below and re-
turn this form to the address listed at the boom. If you have addional comments please feel free to use the reverse side. All of the
informaon is condenal and subject to the Family Educaon Rights and Privacy Act (FERPA) of 1974.
Is this student eligible to connue/return to your instuon? Yes No
_________________________________________________________________________________________________
Comments
Has this student been dismissed from your instuon? Academically Yes No Disciplinary Yes No
_________________________________________________________________________________________________
Comments
Has there been any type of non-academic disciplinary acon with regard to this student? Yes No
_________________________________________________________________________________________________
Comments
Has there been any reason to queson this student’s emoonal stability? Yes No
_________________________________________________________________________________________________
Comments
_________________________________________________________________________________________________
Name Signature Date
_________________________________________________________________________________________________
Title Instuon
Oce of Admissions, Daemen College, 4380 Main Street, Amherst, NY 14226
Transfer Recommendaon Form
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Transfer Recommendaon Form (Daemen College)

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Completed 29 January 2021

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