THE GRADUATE PROGRAM IN ENGLISH

Waiver Form

Waiver of Access: "I (do/do not)                         waive my right to inspect the letter which appears on this form or is attached herewith."

Name (printed): ___________________________________________________________________

Signature:                                                                                                                                                

Name of referee, position, and institution: __________________________________________________

Date:____________________________  Signature:__________________________________________

This form should be sent to: Graduate Admissions, Department of English, Samuel Clemens Hall, Room 306, State University of New York at Buffalo, Box 604610, Buffalo, New York 14260-4610.