Verification / Information Request Form

Please complete this form if you need proof of enrollment for the semester or verification of graduation status. The letter is printed on official letterhead and signed by the University Registrar. Verifications are sent directly to the recipient listed on the form. If you have a form provided by your loan company, insurance company, etc. Please attach the form to this page. Copies of completed verifications letters are available upon your request in the University Registrars Office.

YOUR INFORMATION:

First Name*

Last Name*

Student ID#*

Your Email Address*

REQUEST INFORMATION:

How would you like your verification letter sent?*

Select or enter value

Receiver Contact Information:

Please include the appropriate contact information below (email, fax OR postal address) to send the verification letter.

EMAIL

Receiver Email Address

Fax

Receiver Fax Number

Would you like a copy of your verification?*

Select or enter value

If yes, please provide your Neumann email address

If you no longer use your Neumann email address, please provide an alternative email address that we have on file. Outside email addresses will be compared to the information the University has in your file.

Information to Include*

Full Time

Half Time

Part Time

If you have additional document pertaining to this request to include, you can upload here:

Drag and drop files here or

Would you like to include Anticipated Graduation Date?*

Yes

If yes, please state the month and year (mm/yyyy) for anticipated graduation date

Additional Comments/Requests

Electronic Signature*

I, the requestor, for this form understand that by clicking the box below and providing my signature, warrant the truthfulness of the information provided in this application.

By checking this box you are authorizing the release of this information.*

Cookie/Privacy Policy Acknowledgement*

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