Request For
Enrollment Verification
North Georgia Technical College
Office of the Registrar
PO Box 65, Clarkesville, GA 30523
Phone: 706-754-7768 Fax: 706-754-7777
Email: registrar@northgatech.edu
Please note: Anticipated completion dates will be set in accordance with the number of hours listed in the catalog for the program of study.
Any information released before drop/add period is over will reflect pending status.
Name:
Former Last Name (if any):
Student ID or last 4 digits of Social Security #:
Date of Birth:
City:
State:
Zip Code:
Phone:
(
)
Email:
Enrollment Verification Letter:
1. Select enrollment period for verification:
Fall
Spring
Summer
Year:
20
2. Select a delivery method for the requested Enrollment Verification letter:
Pick up* from an NGTC receptionist on the following campus:
Blairsville
Clarkesville
Currahee
*The Registrar’s Office will call when the form is ready to be picked up by the requesting student. Photo ID is required.
Fax to:
Name:
Fax #:
Email to:
Name:
Email:
Mail to:
Name:
Address:
City:
State:
Zip Code:
3. Indicate Special Requests (if any):
Letter of non-enrollment
Complete the attached form.
Special request for information on letter:
4. Student’s Signature:
Date:
This form should only be used when enrollment information is not available on the Student Clearinghouse Website.
Office Use Only
Registrar’s Office Representative
Date Received
As set forth in the student catalog, North Georgia Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age,
political affiliation or belief, genetic information, disabled veteran, veteran status, or citizenship status (except in those special circumstances permitted or mandated by law). For
complaints or information, contact Mike King, VP of Student Affairs (706- 754-7711, Title VI, IX, II), or Kay Morgan, special services contact (706-754-7828, Sec. 504/Title I/ADA) at 1500
HWY 197 N, Clarkesville, GA 30523.
This institution is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint
Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the
information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue,
S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. 9/14/16
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