Credential Request Form


By submitting this form, I authorize the release of my letters of recommendation, evaluations,
and any other related credential materials to the individual specified below.

Name:
Name at graduation:
Phone:
Email:
Address:



Hanover College Degree Date:
Major:
Minor:
Area(s) of Certification:


Please mail my credentials to (all fields are required):

Name:
Job Title:
Name of Organization:
Address (street, city, state and zip code):


Special Instructions (if any):

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