Student Request Form (SRF)
Instructions
LETTERS
Good Standing
- Letter will contain your name,
UIN, class;
- Letters must be addressed to a
party, either an individual or an organization. We CANNOT address letters
"To Whom it May Concern".
- Whether you are in good standing
(M1 transcripts are not available); or, in good academic standing (M-2,M-3,M-4);
- Month and year of graduation
- Sample
letter of good standing
Good Standing with Malpractice and
Health Insurance Coverage
- Same as Good Standing except the
letter will also indicate that malpractice and health insurance cover you.
Jury Duty
- Letter supporting your exemption
from jury duty.
- Attach original summons and submit
in advance of jury duty date.
- Original summons will be mailed
by OSA.
- Copy of letter and summons will
be mailed to you, unless you indicate otherwise.
- If you receive any other correspondence
summoning you to jury duty, complete another Student Request Form (SRF) and
submit to OSA.
- Sample
jury duty letter
Letter of Recommendation or Support
for Scholarship, Grant, Award, etc.
Completion of Externship Application
- Application will be completed
and letter of good academic standing will be included if required.
IMMUNIZATION RECORDS
- Incoming information will be placed
in the student's immunization file.
- To remove a registration "HOLD",
please identify information to be forwarded to the Office of Immunization,
and/or the employer for employment.
FACULTY ADVISOR
- The faculty advisor "change form"
must be submitted.
- For a reassignment, student must:
- Obtain the signature of the
current advisor.
- If recruiting his/her own
faculty advisor, signatures are required of both the current advisor for
a release,
- and from the recruited faculty
advisor for assignment confirmation.
STUDENT FILE
- Complete a Student Request Form
(SRF).
- An OSA staff will contact you
when your request is available. Note: Requires more than 5 business days.
OTHER ITEM(S)
- Describe exactly what you are
requesting.
- Include any pertinent information,
such as contact person, title, address, telephone,
- Include attachments that may be
needed to expedite your request.
ALUMNI
- Dean's Letter: a copy of your
Dean's Letter will be mailed where indicated.
- Certification: letter verifying
graduation will be mailed where indicated.
- Licensure application: application
will be completed and mailed to State Board
Attachments may be submitted to:
University of Illinois College of
Medicine Office of Student Affairs
1853 W. Polk St. Room 112CMW MC 785
Chicago, IL 60612
Phone (312) 996-2450
FAX (312) 355