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  • Governors State University Immunization Exemption Form 2016

Get Governors State University Immunization Exemption Form 2016

Irth (mm/dd/yyyy): GSU Student ID number: Phone number: Date of request: Reason for Request: Exemption* - Exclusively attend classes at an off-site location. Exemption* - Enrolled exclusively in an online degree program, or all online courses. Note: A new Exemption Form, signed by your advisor, must be submitted every semester on or before the current Immunization Deadline. *Advisor s Signature: Date: Student Signature: Date: Submit this form in person to Academic Resource Center, B121.

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

Filling out the Governors State University Immunization Exemption Form online is a straightforward process that ensures you can apply for an exemption based on your academic circumstances. This guide will walk you through each step, making the process clear and manageable.

Follow the steps to complete and submit your exemption form online.

  1. Click the ‘Get Form’ button to access the Immunization Exemption Form and open it in the editor.
  2. Start by entering your full name in the designated field, ensuring it follows the format of last name, first name, and middle initial.
  3. Input your date of birth in the required format (mm/dd/yyyy). This date helps in verifying your identity.
  4. Provide your GSU Student ID number. This number is crucial for processing your exemption request efficiently.
  5. Fill in your phone number to allow for easy communication regarding your submission.
  6. Enter the date of your request in the format specified, as it is essential for record-keeping.
  7. Select the reason for your exemption by checking the appropriate box. Options include attending classes exclusively at an off-site location or being enrolled solely in an online degree program or all online courses.
  8. Obtain your advisor's signature and date on the form. Ensure this is done every semester before the Immunization Deadline.
  9. Lastly, append your own signature and the date to confirm that the information you have provided is accurate.
  10. Once you complete the form, save your changes, download a copy for your records, and print it if required. Then you can choose to submit it in person or fax/mail it to the appropriate department.

Complete your Immunization Exemption Form online today to ensure timely processing of your exemption request.

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Governors State University Immunization Exemption Form
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