Print Name: ______________________________________________________
Student ID: _______________________ Phone: _________________________
Email:
Signature: ___________________________________ Date: _______________
Enrollment Status: Full-Time Half-Time Less than Half-Time
Fall: ________ Spring: ________ Summer: ________ All Terms:
List year(s) to be verified. Check box if you want all terms attended.
Class Standing: Graduate Professional Sr Jr Soph Fr
Anticipated Graduation Date: ____________________________________
(Semester & Year)
Current Major: _________________________________________________
(Major, Minor, Certificate)
Other: ________________________________________________________
(Degree Awarded, No Attendance, Good Standing, etc.)
Check all that apply:
Mail Letter To: __________________________________________________
________________________________________________________________
________________________________________________________________
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Email Letter To:
Fax To: ( ) _______________________ Attn: ______________________
Pick-Up Letter in Person Copy Original
Letters are processed within two business days.
For Office of the Registrar Use Only: Date Received: _________________
Date Sent :___________ By: ______
COMPLETE ONLY THOSE ITEMS TO BE INCLUDED IN THE LETTER
LETTER OF CERTIFICATION REQUEST
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