PLEASE DO NOT SUBMIT THIS FORM MORE THAN ONCECertificate declaration processing may take up to two weeks to complete. Multiple submission of this form may cause delays. First Name Middle Name Last Name Student ID Number Action Requested Declare Revise Cancel Revise or Cancel Certificate Declaration Briefly, describe the reason why you would like to cancel or revise your PEPP Certificate declaration. Electronic Signature * By completing this section, you are agreeing that the information is accurate to the best of your knowledge. You are also confirming that your PEPP certificate declaration is subject to the approval of a Political Science advisor.