Revised 8/20/12
Request for Enrollment Verification
NOTE: GCSU certifies for current and past terms only. Requests will be processed for paid registrations after the drop/add period.
Name
Date:
Mail
Pickup
Attn:
Local Phone #
Email Address
Mail to:
Address
City
State
Zip Code
Fax to:
Standard Certification for health insurance, dental insuracne, loan deferment, etc.
Georgia College & State University
Good Student Discount (shows GPA)--requires signature of student
Comments:
Type of Certification Requested
GCID #
Student's Signature:
Date
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome