OFFICE OF ADMISSIONS AND RECORDS
P.O. Box 2216 | Decatur, AL 35609-2216
In accordance with Policy 801.01: Admission: General, all applicants
must provide one (1) primary form of identication.
Name _____________________________________________________________ A Number: _______________________________
One primary form of identication
Type of identication: _______________________________________________________________
Signed _____________________________________________________________ Date ______________________
COLLEGE REPRESENTATIVE
Oce Use Only
Rev. 10/2019
OFFICE OF ADMISSIONS AND RECORDS
P.O. Box 2216 | Decatur, AL 35609-2216
In accordance with Policy 801.01: Admission: General, all applicants
must provide one (1) primary form of identication.
Name _____________________________________________________________ A Number: _______________________________
One primary form of identication
Type of identication: _______________________________________________________________
Signed _____________________________________________________________ Date ______________________
COLLEGE REPRESENTATIVE
Oce Use Only
Rev. 10/2019
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