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  • Governors State University Immunization Exemption Form 2017

Get Governors State University Immunization Exemption Form 2017

Student Health & Counseling Center 1 University Parkway University Park, IL 60484 708.235.7154 Fax: 708.235.3961 www.govst.edu/immunizationsImmunization EXEMPTION Forename:(last, first, middle)Date.

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How to fill out the Governors State University Immunization Exemption Form online

Completing the Governors State University Immunization Exemption Form online is a straightforward process, designed to help users effectively communicate their exemption request. This guide will provide you with step-by-step instructions to ensure that you fill out the form accurately and efficiently.

Follow the steps to successfully complete your exemption form

  1. Click the 'Get Form' button to access the immunization exemption form. This will allow you to open the document in your preferred editor.
  2. Begin filling out the form by entering your last name, first name, and middle name in the designated name field.
  3. Input your date of birth in the format mm/dd/yyyy to help verify your identity.
  4. Enter your GSU student ID number in the appropriate field to associate your request with your student record.
  5. Provide your phone number so the Student Health & Counseling Center can contact you if needed.
  6. Fill in the date of your exemption request to document when you submitted the form.
  7. Select the reason for your request from the provided options, indicating whether you exclusively attend classes at an off-site location or are enrolled exclusively in an online degree program.
  8. Secure your advisor's signature and date on the form, as this is required to validate your exemption request for the current semester.
  9. Sign and date the form as the student, confirming that the information provided is accurate.
  10. Once you have completed the form, you can choose to save changes, download, print, or share the document as needed before submitting it.

Submit your completed form online to ensure your immunization exemption is processed in a timely manner.

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Governors State University Immunization Exemption Form
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