Complete this form by June 15, 2017.

PREDENTAL COMMITTEE LETTER OF RECOMMENDATION STATEMENT OF CONFIDENTIALITY.  Under the provisions of the Family Educational Rights and Privacy Act, I have waived my right to see any of the letters in my pre-dental file.  I understand that the contents of these letters will not be available to me now or at any time in the future. (Do not sign if you wish to retain your right to see these letters).