____________________________________________________________________________________
REQUEST FOR VERIFICATION OF STUDENT ENROLLMENT
(Allow 3 business days for completion of the verification)
Mail request to: Registrar’s Office, Randolph-Macon College
P.O. Box 5005, Ashland, VA 23005
Or Fax request to: Registrar’s Office, (804) 412-2020
Please provide the following information when requesting a verification of student enrollment. Note that such verifications do
not take the place of an official transcript for stating student grades, but may be used to inform insurance providers of full-time
status, assist with student loan deferments, provide verification of eligibility of auto insurance good student discounts, assist
with the obtainment of recent graduate auto loan discounts or student travel discounts for study abroad. (See bottom of page)
STUDENT’S N!ME_______________________________________ I. D. #_____________________
Birth date: _________________________ Student Status: _____________________________
INFORMATION NEEDED: (Check all that apply)
Full time/Part Time status for: current semester past semester next term
GPA: cumulative (all terms combined) last semester only
Graduation information: Expected graduation date Expected degree
General Information: Major(s) Minor(s) Total hours earned Dean’s List
Other: Please list any additional information required to be on the verification.
FOR HEALTH INSURANCE VERIFICATIONS, PLEASE PROVIDE THE FOLLOWING:
Name of Person/Parent on Policy:___________________________________________________________________________
I.D. #:______________________________________ Group #:____________________________________
Additional information, if necessary:________________________________________________________________________
PLACE YOU WISH THE VERIFICATION TO BE SENT:
NAME & ADDRESS OR FAX #_____________________________________________________________
Student’s Signature: _______________________________________Date: _______________________
You now have 24/7 access to verification services from the National Student Clearinghouse
with no wait time. Verifications are completed at the time of the request!
The National Student Clearinghouse provides the following services
Enrollment Verification Certificates to send to health insurers, housing providers, etc.
Deferment forms and electronic notifications to send to lenders.
A list of your student loan lenders and a link to real-time loan information.
Your enrollment history at Randolph-Macon College.
For more information visit: www.studentclearinghouse.org
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