Forms
A full list of forms used by Student Affairs is below. Those forms not available online (whose titles are italicized) may be obtained from the Student Affairs Office, Pharmacy Hall, Suite 722.
Add/Drop Form - Official Change in Registration
Used for all changes in registration, adds and drops, audits, repeats, and section changes. Students complete and return the form to the Student Affairs Office.
Advisor Change Form
Used to change advisors. Students complete the form, have the new advisor sign, and return it to the Student Affairs.
Advising Contact Sheet
Used by advisors to document the contents of meetings with advisees. Advisors complete and keep form for advisees’ file.
Application for Diploma
Used to apply for graduation. Students complete and return the form to the Office of Records and Registration. (May also be submitted on-line through SURFS.)
Application for Inter-Institution Enrollment
Used to enroll in courses at affiliated USM institutions. Students complete and return all copies of the form to the Student Affairs Office.
Application for Withdrawal
Used to withdraw from the School of Pharmacy. Students complete, obtain the appropriate signatures, and return the form to the Student Affairs Office, 722PH.
Change of Discussion Group
Used to switch from an assigned group during the first week of classes. Students must get someone currently in the group they wish to join to switch to the group they wish to leave. Both students are required to sign the form, and the student requesting the change must return the form to the Student Affairs Office.
Consent - Release of Confidential Information for Letter of Recommendation
Completed by students to give permission to release information about grades, class rank, etc for letters of recommendation.
Consent - Release of Student Information
Completed by students to disclose confidential information about the student.
Consent - Student Affairs Request Form
Completed by students and submitted with other Student Affairs forms to release confidential information for dual degree program admission, Visa status, deferment, etc.
Degree Certification Request Form
Used to request the University of Maryland Baltimore verify degree record.
Dual Degree Statement of Intent Form
Used to assist students in declaring their intent to pursue one of the dual degree programs. Each semester students must have this form updated and signed by the administrator. This statement must be returned to the Office of Student Affairs along with the student’s Plan of Study prior to the start of each semester’s registration process.
Dual Degree Request for Extra Financial Aid
Used to request extra financial aid for courses offered during the summer.
Financial Aid Form
Used to apply for federal financial aid. Students may pick-up the form Request for Financial Aid Application for UMB from the Student Affairs Office, complete and return the form to the University's Student Financial Aid Office.
ID Authorization Form
Used to obtain a photo ID and to access Pharmacy Hall, Allied Health, HFSII, 515 Lombard Building, and Pharmacy Learning Center. Students complete and return the form to the Pine Street Police Station. A replacement fee must be paid if the ID is lost.
Plan of Action to Remediate Failing or Incomplete Grades
Used by students who have failing or incomplete grades in required Doctor of Pharmacy courses on their official transcripts. Students must complete the Plan of Action to describe how they will remediate failing and/or incomplete grades to passing grades. This form must be signed by the coursemaster and submitted to the Student Affairs Office.
This form is also available as a Word document.
Plan of Study
Used to help students' long range planning for electives (PHMY and PHEX) and for graduation requirements. Students must submit an updated form each semester, signed by their advisors, to the Student Affairs Office, 722PH.
Special Events Request Form
Students complete this Dean's Office form to arrange to have an event on or off-campus. This form is also available as a Word document.
Special Studies Faculty Evaluation Form
Used for faculty mentor’s evaluation of student performance. This form is also available as a Word document.
Special Studies Registration Form Special Studies Registration Form
Used to describe special projects students want to complete during the semester. Students complete and get signatures on the form from the course master and return the form to the Student Affairs Office by the first week of class.
Student Address Form
Used to change address. Students complete and return the form to the Student Affairs Office. This form may be obtained on-line through SURFS.
Student Grievance Form/Grade Appeal
Student should complete this form to file a grievance or appeal a grade.
Student Special Events Request Form
Students should complete this form when planning an event.
Transcript Request Form
Used to request a transcript.
Tutor Contract
Used for students who agree to provide peer tutoring service to other students. Students need to complete and return the form to the Student Services Office before they are assigned tutees and put on the payroll.
Tutoring Acceptance Agreement
Used for students who agree to receive peer tutoring service from other students. Students complete and return the form to the Student Services Office.
Verification of Attendance
Provides proof of current enrollment. Students may obtain the letter from the Student Affairs Office by completing the Concent - Student Affairs Request form above.