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PDF ENCRYPTION HOW TO GUIDE t Ac ademic Year Statement - HPSP Form - 26Aug 2015(fillable).pdf -Adobe Acrobat Pro DC Help 6li 181 Q i 1 , 1 e .ti NAVY HPSP ACADEMIC YEAR STATEMENT ln order to establish an exact benefit start date, the student and the school registrar must complete the information below. AII information should be filled in and the form sent to the Navy Medici ne Accessions Department. lf received without proper school endorsement, signatures, or incomplete fields, tuition and/or benefit payments may be affected and it will be sent back to the student for completion. Please email completed form, as well as any questions to: USN0HSTUDENT@MAILMIL PLEASE PRINT CLEARL Y! Student lnformation Full Nameof Student Last Four of Social Securily Number E-mail Address LEAVE BLANKI Program: O Medical O Dental D 0ptometry O Podiatry O Clinical Psychology School Name: SchoolAddress:. (Street, City, State, and Zip

Code) Asaparticipant in theArmedForces Health ProfessionsScholarshipProgram, I hereby authorize myuniversity to releasea// information concernina mvacademicoerformanceandlor enrollment status to theNavv MedicineAccessions Deoartment Bureau ! Aca demic Year 5tatement · HP5P Form · 26 Aug2015(/illable).pdf · AdobeAcrobat Pro DC Ho ocument Q ~ea rch Tools. ~ CJ □= D e ~o Create PDF Edit PDF Export PDF Comment Open "j Open " Open " Open " Organize Pages Open " Enhance Scans Open " Open " 12 ~ ~ ~ -o- 12. 8 ~ Fill &Sign Prepare Farm Combine Files Optimize PDF Redact Stamp Compare Documents Open • J Open • Add " Add " Add " Add " Add "j l?e ~ ~ ~ fi ~ (t) Send far Comments Action Wizard Create Custom Tool Print Production PDF Standards Certificates Accessibility Add "j Add " Add " Add " Add " Open " Add

"J □ -, ~ A cad e m ic Ve a r St at e m e nt - HP SP Fo rm - 26 A u g 2015(fill able) .pdf - A dob e A c rob at P ro DC Fil e Ed it Home View W in dow Tools X H e lp Documen t ~ Rest rict Edit ing / 1 ~ En crypt ,. ~ M ore Opt ions ,. X 1. En cnyp t w it h Gertifi cat e NIA NT 2 Encryp t w it h Passw o r d ~ M anage Se<curity Po li cies . ln ·o rd erto esfabl ish an exact lben efit start date, t h e stu information belo w . AH info:nn ation slho uld b e fii ed i n an d the form sent to tl,. , ,ceived witihout proper sohoo l endorsement , si gnatures. or in complete fi elds t11 ition an d/o r be1n efit paym ents m ay b e affécted and it wi I be sent badk t o the sw den t fo:r comp letio:n . Please em ail comp eted fo1111, as w ell as a:ny q u estion s t o: USN0HSTUDENT@rl/llAILMI PLEASE PRI Nl CLEARLY! Stude1 n ·t I nforma•t ion Full Name of Student Last fo1J r of Sooial Secmi ly Number E-mail Address LEAV E B LAN K Pro

gram: O Medk al 0 De nt all Optomefry D Podi.atry D c i nica l Psydho logy School Name: School Ad dr,e ss : . , (Slireet , Cit y, Stailie, an d Z i1p Cod e) As a parlicipant in lhe A rmed Forces Health Pmfession s Scholarship Program, I hereby authorize my university to release afl in.formatfon conceming my academic pe rtormance amllor enmlfment sta tus to the Navy Medicine A cressions Depa rtment Bur;eau of Medicine and Surgery, ff requested. ST UDENT SIGNATUR E: DATE : □ -,.• Academic Year Statement - HPSP Farm - 26 Aug 2015-(fillable)pdf - Adobe Acrobat Pro DC Fil e Ed it Home View Wind ow Tools X He lp X Docu1m ent / 1 [i Res.t rict Edi t ing ÍI En crypt T ~ M ore Opt ions. T NAVY HPSP ACADEM I C YEAR STATEMENT ln order to establish an exact benefit start date, the student and the school reg istrar must complete the

information below. AH information should be filled in and the form sent to the lfavy Medicine Accessions IDepartment. lf rece ived with out proper school endorsement, signatures, or incompl!ete fi elds, tuition and/or benefit payments may be affected and it will be sent back t.o the student for completion Please email completed form, as well as any questions to: USNOHSTUDENT@MAILMIL PLEAS E PRINTCLE,,.,~ - - - - - - - - - - - - - - - - - - - - - - - - ~ App lyin g New Security Settin gs X Are yo u su re y o u w ant t o ch an ge th e secu rity o n t h is do cu m ent ? Full Na D Do not show th is m essag e a ga in Program: 0 Me 1ca School Name: School Address: . (Street, City, State, and Zip Code) As a participant in the Am1ed Forces Health Professions Scholarship Program, 1hereby authorize my university to release all information conceming my academic performance andlor enrollment status to the Navy

Medicin e Accessions Oepartment, Bureau of Medicine and Surgery, if reques/ed. STUDENTSIGNATURE: DATE: X " X Password Sec urity - Settings Docum ent Open 0 Require a password to open th e do cum ent Docum ent Open Password: J,J,J,J.JAAAJJJ, I - - -- Strong This password will be required to open th e docum ent. Permi ssions D Restri ct editing and printin g of th e doc um ent. A password will be required in order to chang e th ese permi ssion settin gs, Printing Allowed: High Resolution Changes Allowed: Any except extracting pages Enable copying of text, images, and other content Enable text access for screen reader devices for the visually impaired Change Permissions Password: - - - - NotRated Options Com patibility: 1 Ac robat 7.0 and later v I Enc ryption Levei: 128- bit AES @ Encrypt all docum ent contents Ü Enc rypt all doc um ent contents except metadata (Acrobat 6 and later compatibl e) 0 Enc rypt only

fii e attac hm ents (Acrobat 7 and later compatibl e) AII contents of th e docum ent will be encrypted and sea rch engin es will not be able to access th e docum ents metadata . Help . o K .I l. c a nc e l