Permission to Release Course Grade Information
To the Registrar’s Office, Kent State University, Kent, Ohio:
I have applied for membership in Kent State University’s chapter of the Foreign Language International Honor Society PHI SIGMA IOTA. The selection criteria are as follow:
Members are selected from outstanding advanced undergraduate students (juniors and seniors), and graduate students pursuing a curriculum with emphasis in foreign language. Undergraduate students must: 1) have completed at least 3 semesters of the college course, 2) have completed at least one foreign language course at the third-year level (30000 and above), 3) have at least a B average in all course work and, 4) be currently enrolled. Graduate students must: 1) have completed at least one full semester at KSU, 2) have the highest degree of competence in at least one foreign language and, 3) have a B+ average in all graduate work and in all courses in the foreign language.
In order to determine whether I qualify for the upcoming initiation during honors week in April of this year, my grade point averages for (a) my overall course work; and (b) my work in language courses need to be verified. Hereby, I give you permission to release the pertinent information to Dr. Hildegard Rossoll, Faculty Advisor of PHI SIGMA IOTA.
______________________________________________ _________________________
(Signature) (Date)
Name: ____________________________________________________________________
(Last) (First) (Middle)
Student ID No.: ____________________________
Social Security No.: ____________________________
Local Mailing Address: ____________________________________________________________________
____________________________________________________________________
Overall Grade Average: _______ (Undergraduate) _______ (Graduate)
Grade Average in Foreign Language Courses: _______
Major field of study: ____________________________
Minor: ____________________________