Verification of Enrollment Request
Student Information
Last Name: First Name:
Middle Name:Former Name:
Student ID: Date of Birth:
Address:
City, State, & Zip: Phone:
Email Address:
13650 Apple Harvest Drive
Martinsburg, WV 25403
TEL: 304-260-4380
FAX: 304-260-4376
www.blueridgectc.edu
Verification can only be completed for currently enrolled students. You must be registered for
the semester you are requesting verification.
If a GPA is needed, students do not have a GPA until they have completed at least one semester
at Blue Ridge CTC.
All Blue Ridge CTC students are undergraduate students.
Date:
Student Signature:
Processing Information
Semester for which verification is needed:
Fall (Year):
Spring (Year):
Summer (Year):
Expected date of graduation is needed on verification:
Yes, it is required No, it is not necessary
Financial Aid & Pell Grant info is needed on verification:
Yes, it is required No, it is not necessary
Are you a full time student?
Yes, more than 12 credits No, less than 12 credits
Mailing Information
Mail (complete address below) Fax (List complete number and person) Student Pick Up (ID Required)
Institution or Agency Name:
Office or Person:
Complete Address:
City, State, and Zip:
Fax Number (if faxing):
Enrollment Services Signature: Date Sent:
Updated: 8/29/2017
Blue Ridge Community and Technical College
provides opportunity to all prospective and
current members of the student body, faculty,
and staff on the basis of individual
qualifications and merit without regard to
race, color, sex, sexual preference, religion,
age, national origin, sexual orientation,
marital or parental status, familial status,
veteran status, or disability.
Enrollment Verifications are FREE from your Bridge account. To access verifications, go to Student Services > Student Records >
National Student Clearinghouse > Choose Current enrollment or All enrollment and Click on 'Obtain an enrollment certificate", this will
open your enrollment verification in a PDF format immediately.
Should you choose not to use the free, online verification, a payment of $10.00, payable at the Cashier's Office, is due prior to processing
form manually.
