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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