Enrollment Verification Request
Full Legal Name_____________________________________________________________________ ______
Student ID Number _______________________________ Date of Birth _________________
Telephone Number ________________________________
Permanent Address ________________________________________________________________________
__________________________________________________________________________________________
E
mail Address ___________________________________________________
VERIFICATION OF (check all that apply):
Indicate the appropriate term you are requesting reclassification:
Current Enrollment Status
Enrollment History
Cumulative GPA
Anticipated Degree and Date
Conferred Degree and Date
Other ____________________________________________________
Check to include Social Security Number
Check to include embossed seal (items with embossed seal cannot be faxed)
Please include: _______________________________________________________________________
RECEIVING OPTIONS:
P
ick up on (allow 2 business days for processing) _________________________
F
ax Number: _________________________________ Attn: ________________________________
Mail to: _____________________________________________________________________________
Student signature ___________________________________________ Date _________________________
Please return completed form to the Records Office
710 Colegate Drive
Marietta, Ohio 45750
Fax: 740-568-1965
recordsoffice@wscc.edu
Fo
r Office Use: Date processed ____________________ by ________________________________________
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