Center for Academic Success and Registrar ● PO Box 770 ● Georgetown, TX 78627
Phone: 512-863-1952 ● Fax: 512-863-1685 ● registrar@southwestern.edu
S:\Registrar\Forms\Verification of Enrollment SU18
VERIFICATION OF ENROLLMENT
PLEASE CLEARLY PRINT ALL INFORMATION
STUDENT INFORMATION
Name:
Last First Middle
Student ID or SS#: Date of Birth:
SU Email: @southwestern.edu Phone:
INFORMATION REQUESTED FOR VERIFICATION (SELECT ALL THAT APPLY)
Verification of Enrollment (full- or part-time status)* Fall 20 Spring 20
Select one or more
Verification of Degree Completion
Number of Credit Hours Cumulative Fall 20 Spring 20
Select one or more
GPA
Printed Class Schedule Fall 20 Spring 20
Select one or more
Other:
* Southwestern University can only verify enrollment for the current semester or upcoming semester(s) in
which the student has already registered for classes.
SEND VERIFICATION TO
Individual/Company Name:
Address:
City: State: Zip Code:
Fax Number:
Email:
I certify that I am the person whose name appears on the student’s name line of this form and do
hereby authorize release of the requested academic information to the person or company indicated.
Student Signature: Date: