In an effort to continue to serve our students, please contact us using the information below.
All forms can be emailed to us for processing once approved.
PHONE: (631) 632-6175
FAX: (631) 982-7320
Looking for a form? You've landed in the right place.
You must be using Adobe Acrobat Ver. 6 or later to use our forms. You may download
this free program from
Authorization to Release Information - to authorize (or revoke) release of information related to your educational record to another individual
Suppression of Directory Information - to suppress or remove the suppression of directory information
Student Reference Request Form - to authorize faculty to release information in a letter of reference
Request to Inspect and Review Educational Records - to request access to review your educational records
Permission to Drop - to Drop Co-Required course or Drop with Permission Courses Only
Time Conflict - CAS, COB, MSRC, SOJ, SBS Students
Time Conflict - CEAS Students
Undergraduate Semester Withdrawal -
(University Withdrawal, Leave of Absence-LOA, or Medical Leave) - Available Now
for Spring 2020
Application for Graduation - for Health Sciences Students - u se this form at the direction of your academic program only if you are not able to apply for graduation through SOLAR
Change of Graduation Date / Diploma Address / Middle Name - for Health Sciences Students that have already applied for Graduation and wish to change the Graduation Date, update their diploma address or add their middle name.
eSign Available for Select Forms
Using an electronic signature is quick and easy, but it does require a few steps to set up your signature for first time use. Learn More about eSign.
Once you have completed the eSign process you will need to upload your form. Learn more about Uploads.
Falsification of signatures may result in an accusation of Academic Dishonesty. The Office of the Registrar retains all submitted forms electronicaly.