Verifi cation of Enrollment / Degree
Registrar’s Offi ce
Student & Administrative Services Center, Rm. 1020
Return to:
Pennsylvania College of Technology, DIF 114
One College Avenue
Williamsport, PA 17701-5799
Or fax to: 570.321.5536
Student name _______________________________________________________________________________________________
PCT ID ____________________________________ or Social Security number* _______________________________________
The following information will be verifi ed:
Name Current enrolled degree(s)
Enrollment status Expected date of graduation
Date(s) of attendance - past, current, future Date of birth
Major(s) Mailing address
Degree(s) conferred Good standing statement
This letter is to be:
q Picked-up in the Registrar’s Offi ce, Student & Administrative Services Center, Rm. 1020
q Mailed to ________________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
q Faxed to ________________________________ Attn: ___________________________________________
If sending verifi cation to an insurance company, please include the policyholder’s name and identifi cation
number or include any additional information here:
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Requestor’s name ___________________________________________________________________________________________
Requestor’s signature _______________________________________________________________________________________
* The Registrar’s Offi ce requests your Social Security number for the purpose of verifying your identity with your offi cial educational records. If you
do not provide your Social Security or PCT ID number, the College cannot guarantee the authenticity of your educational records. The College will
not disclose Social Security numbers to anyone outside of the College without an individual’s consent except as mandated by law.
Note: We do not include PCT ID or Social Security number on the verifi cation.
PC1345 4/20
