Parent School
Eastern Oregon University
Inlow Hall 105
One University Blvd.
La Grande, OR 97850
T. 541-962-3504
F. 541-962-3799
Veterans Certifying Official contact:
Email: djones@eou.edu
Secondary School
Institution: Addresss:
VA E-mail:
VA Office Phone:
VA Office FAX: Certifying
Official Name:
7/15
Parent School Letter Request
School information
Personal information
________________________________________________________________________________________ _____________________
Student Name Chapter
___ ___ _____Your Date of Birth** / / MM/DD/YYYY
Student ID Number _______________
EOU ID
Student ID Number: ___________________
Secondary School ID
_______________
________________
Cell Phone Work Phone
_____________________________________________________
E-mail address
To be completed by an EOU Academic Advisor
This is to certify that the above student is pursuing the following program: _________________________________________________________
The course(s) listed below satisfy the program requirements and will transfer, if completed, to Eastern Oregon University.
Course Number and Title at Secondary School
EOU Course Equivalent
Student intends to take the above course(s) at the above listed secondary school for the following term:
r
Fall
r
Spring
r
Winter
r
Summer of _______ (year)
r
Other
_____________________________________________ _______________________________________________ _________________
Advisor Name Advisor Signature Date
_____________________________________________ _______________________________________________ _________________
Student Name Student Signature Date
Note: Form must be filled out complete. Incomplete forms will not be processed.
___________________________________________________________________________________________________________________
OFFICE USE ONLY
_____________________________________________ _______________________________________________ _________________
Certifying Official’s Name Certifying Official’s Signature Date
Primary Phone
Cell
Work
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
