Enrollment Verification Form Rev 5/04/2020
Access and Enrollment Services
UNIVERSIT Y O F THE VIRGIN ISLANDS
S T U D E N T E N R O L L M E N T V E R I F I C A T I O N R E Q U E S T F O R M
Instructions:
1. Complete the form below to request parts of your academic record be verified to outside
institutions.
2. Email the completed form to the Office of the Registrar at registrar@uvi.edu
3. Please complete one form for each request.
4. Requests are typically processed in 2 to 3 business days.
Student Name: __________________________________ Maiden Name (s): _____________________
Student ID: _____________________________________ Contact Phone: ________________________
Date of Birth : __________________________________ Date Requested: _______________________
Email Address:___________________________________________________________________________
Please send a verification of my academic record via:
Email Address Name: ____________________________________________________________
Email Address: _____________________________________________________
Parent Name/Signature __________________________________________________________________
(Note: if student is under age and making request on behalf of the student)
Student Signature____________________________________________________________________
Some of these items are considered confidential information and require a student signature.
Please check below the appropriate boxes on your request:
Indicate semester to be verified: spring fall
Matriculation Date (start Date) Anticipated/Graduation Date
Dates of Attendance Full-time/part-time status
Level (undergraduate, graduate, etc.) Status (freshman, sophomore, junior, senior, etc.)
GPA (grade point average) Current Credit Hours
Never Attended
Note: The Family Educational Rights and Privacy Act (20 U.S.C. § 1232g; 34 CFR Part 99), as revised, states (a) An educational agency or
institution may disclose personally identifiable information from an education record of a student without the written consent of the parent of the
student or the eligible student if (1) The disclosure is to other school officials, including teachers, within the agency or institution has determined to
have legitimate educational interests. (2) The disclosure is to officials of another school or school system in which the student seeks or intends to
enroll.
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