PUBLIC NOTICE OF NONDISCRIMINATION: Northland Pioneer College does not discriminate on the basis of race, color, national origin, veteran status, religion, marital status, gender, age or disability in
admission or access to, or treatment or employment in its educational programs or activities. District grievance procedures will be followed for compliance with Title IX and Section 504 requirements. The Afrmative
Action Compliance Ofcer is the Director of Human Resources, 2251 E. Navajo Blvd., Holbrook, Arizona 86025, (800) 266-7845. The Section 504 Compliance Ofcer is the Coordinator of Disability Resource and
Access, 1001 W. Deuce of Clubs, Show Low, Arizona 85901, (800) 266-7845. The lack of English language skills will not be a barrier to admission and participation in vocational education programs. Revised 9-12-14
Marketing/Forms/R&R/Enrollment & Admission Verication Request Revised April 29, 2019 EcR
P.O. Box 610, Holbrook, AZ 86025-0610
2251 E. Navajo Blvd. Painted Desert Campus Tawa Center
Phone: (928) 524-7459 or (800) 266-7845, ext. 7459
FAX: (928) 524-7461 • transcripts@npc.edu
Admission
and/or
Enrollment Verification Request
Full Name: NPC Student ID #:
Mailing Address:
City: State: ZIP Code:
Contact Phone: Email Address:
I am authorizing release of my educational information as stated above. I understand my account must be clear of all holds before the letter(s) will be
released. By submitting this form, I certify that the information I provided is accurate. I have not given false or misleading information, I understand that
if it is found to be otherwise, it is sufficient cause for rejection or dismissal.
Signature:
Complete this form on your computer, then Print a copy, Sign, and submit to the Records & Registration Office
at the address shown above, or drop off at any NPC campus or center office to be forwarded to the office.
5
Select Semester and Year of planned admission:
Semester: Year:
Recipient:
Mailing Address:
City: State: ZIP:
5 Send Test Scores to the Above Address
Select Test Scores to Include:
I would like a Letter of Admission
5
We can only provide Verification for the current semester or one
semester prior.
Select Semester and Year of planned admission:
Semester: Year:
5 Check if Recipient is same as Letter of Admission
OR
Recipient:
Mailing Address:
City: State: ZIP:
Additional Information Required:
(Not all requests can or will be fulfilled)
I would like an Enrollment Verification
(Letter will state full-time or part-time status; semester enrolled; number of credit
hours; and the semester start and end dates.)
