Paul D. Camp Community College – Request for Letter of Non-Attendance

Complete all required fields below. Once finished, click Print to PDF at the bottom of the form, choose Save as PDF as the destination, and email the completed PDF to the College Registrar at cricks@pdc.edu, or mail it to 100 North College Drive, Franklin VA 23851.

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Personal Information

First Name

Last Name

Birth Date

Last 4 Digits of SSN Enter the last 4 digits only

Former Name(s)

Request Details

By signing this form, I hereby request that the Registrar's Office of CAMP Community College provide a Letter of Non-Attendance to the individual or organization identified below.

Individual or Organization

Address

Applicant Signature

Signature

Date

Please email this request to the College Registrar at cricks@pdc.edu or mail it to the address listed above.

Registrar Office Use Only

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Date