If you wish to request a jury duty release letter from the Dean of Student Affairs, please provide the information requested and submit this request to the Dean of Student Affairs, Dr. Ping-Tsao at email@example.com.
Last: First: Middle:
JUROR INFORMATION (Number, type, Date(s) of Jury Duty/Court Service):
WHAT COUNTY IS THIS HELD IN:
STUDENT’S GRADUATION DATE:
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