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Northwest Missouri State University

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Request for a Senior Deficiency Statement

Today's Date:
Name:
Social Security Number:
Student ID Number (919#):
Local Address:
Email Address:
Major:
Minor:
Advisor(s):
Degree:
 B.S. in Education
Bachelor of Science
Bachelor of Arts
Bachelor of Fine Arts
B.S. in Clinical Laboratory Sciences
Bachelor of Technology
Year of Catalog :
 2008-2010 (colden hall)
 2006-08 (aerial view)
2004-06 (centennial)
2002-04 (gray/green)
2000-02 (int'l plaza)
1998-00 (dark green)
1996-98 (admin bldg)
1994-96 (green)

Please complete this form for forwarding to your advisor along with a transcript. Senior statements are finalized in the Registrar's Office after the advisor has listed major/minor deficiencies.