Rev. 2/20/20
OFFICE OF THE REGISTRAR
59 College Avenue
Buckhannon, WV 26201
Office: 304-473-8046
Fax: 304-473-8531
registrar@wvwc.edu
ENROLLMENT VERIFICATION REQUEST
TO BE COMPLETED BY STUDENT
NAME ____________________________________________ DATE OF REQUEST ________________
SIGNATURE (required) __________________________________________
REQUIRED FOR INSURANCE PURPOSES ONLY
Insured Parent’s Name __________________________________________________
Address ______________________________________________________________
______________________________________________________________
Employer _____________________________________________________________
Please indicate method of delivery: ______US Mail _____ Email _____Fax _____Pickup
Name ________________________________________
Address ______________________________________
_______________________________________
Email _______________________________________
Fax # _______________________________________
Registrar Office Use Only
This is to certify that the above name student is currently enrolled as a:
_____ Full time _____ Half time _____ Less than half time - # hours ______
Semester of verification _________________________
Beginning Date of attendance ____________________ Ending Date of attendance ____________________
Anticipated Graduation Date __________________ Degree _______________
What date did student first enroll at Wesleyan _____________________________
Respectfully submitted,
_________________________________
School Seal Registrar
