Enrollment Verification Request
Last Name: _________________________ First Name: ______________________ Middle Initial: ________
Student Number: _________________________
Term(s) to verify: Fall Spring Summer 20____ All
Please verify the following:
Dates of Attendance Cumulative GPA Term GPA Full-Time Status
Degree Completion See Attached Form Other _____________________________
Hold for pickup Special Instructions
Mail (use the space below for address) ____________________________________________
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Signature: _______________________________________________ Date: _________________________
Please allow 2-3 business days for processing.