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Dean's Certification & Disciplinary Records Request (External Agencies)


This form is for academic institutions and employers to request confirmation of a student/alumni’s disciplinary record as part of an application for admission or employment. Please note that you will need to provide a signed release from the student/alumni for this information to be provided.

At the University of Illinois at Chicago (UIC) this clearance process is referred to as the Dean's Certification. Dean's Certifications are coordinated by the Office of the Dean of Students and include student disciplinary record information for both academic and non-academic misconduct. These requests are typically required by graduate and professional schools, state bar associations, government agencies, or independent agencies when applying for admission or employment.

Students and alumni must provide a signed release form providing the University permission to release this information. If you already have a form you have signed as part of your inquiry, please upload it in the "Supporting Documentation" section. If not, have the student/alumni complete the Consent to Release Records (FERPA).

Please allow 5-7 business days for your request to be processed. If you have any questions, please contact the Office of the Dean of Students at 312-996-4857.

Requester Information

If you are requesting this information on behalf of a student/alumni of UIC, please complete the following information for us to follow up with you if we have any questions or concerns.

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Student/Alumni Information

Please provide all of this information; if you do not know/recall the student/alumni's UIN number, you may leave that field blank. You must provide the student/alumni's current phone, address, and email in case we need to make contact for clarification.

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Additional Information about Student/Alumni

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Supporting Documentation

Please be sure to complete, sign, and attach the following documents to ensure timely completion of your request: (1) Any documents/forms from the institutions to which you want us to send a report; (2) A completed Consent to Release Records (FERPA) that lists each institution to which you want us to send a report; 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

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