SIMMONS UNIVERSITY
Office of the Registrar
300 The Fenway, Boston, MA 02115
Tel 617.521.2111 Fax 617.521.3144
VERIFICATION REQUEST FORM
Current Name:
Name During Attendance:
Simmons ID #:
Approximate Dates of Attendance:
Anticipated Completion Date:
Degree Earned (if applicable):
Date of Birth: / / Daytime Phone:
E-mail Address:
Verification TYPE:
TYPE OF REQUEST
DESCRIPTION
# OF
COPIES
Enrollment Verification
An Enrollment Verification is for current students to
show the number of credits registered for each semester
and the corresponding status, as designated by number
of credits. This form also lists the anticipated graduation
date and anticipated degree to be earned.
Degree Verification
A Degree Verification is used to show that a student
graduated from Simmons University, and lists the
conferral date and the type of degree earned.
Method of Obtaining Verification:
Pick Up (Please note that we will only hold the item for 3 months. We will only release the item upon presentation of a photo ID.)
Send out (if sending out, fill in information below).
If Sending Verification: Provide mailing address (FILL OUT ONE FORM PER ADDRESS)
To Mail:
Name of Recipient
Street
City, State, Zip
To Email or Fax:
Email or Fax
Signature: Date:
06/25/2020
click to sign
signature
click to edit
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