Fillable STATEMENT OF ENROLLMENT (Name of College) (LINECO)

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STATEMENT OF ENROLLMENT (Name of College) (LINECO)

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Lineco Member Name:
Unique ID:
STATEMENT OF ENROLLMENT
STUDENT:
To the Registrar of : _____________________________________________
(Name of College)
______________________________________ ( )_____________________
(Complete address of College) (Telephone # of College)
I HEREBY AUTHORIZE ______________________ TO RELEASE TO THE LINE
CONSTRUCTION BENEFIT FUND, INFORMATION REGARDING THE CLASSES
AND UNITS
CARRIED BY ____________________ AT THE ABOVE NAMED SCHOOL.
Employee: ___________________________ Date: ___________________
Student: ___________________________ Date: ___________________
1. Is the above student enrolled and recorded as a full-time student
during the current semester? ___Yes ___No
This semester begins on ___________ and ends on ____________.
2. Was the above student enrolled last semester? ___Yes ___No
Last semester began _________ and ended _______________.
Units Carried # _______.
3. How many units constitute a full-time student at this
institution? ______.
4. Please advise if any units were dropped. If so, date and number
of units dropped? ___________________________________
5. What is the Student's classification? Please circle one:
Freshman Sophomore Junior Senior
*REGISTRAR-PLEASE VERIFY ENROLLMENT STATUS AFTER THE ADD/DROP
PERIOD HAS
ENDED.
________________________ ____________ _____________________________
(Registrar Signature) (Date) (Anticipated Graduation Date)
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STATEMENT OF ENROLLMENT (Name of College) (LINECO)

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Completed 15 January 2021

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