Verification of Enrollment Form

Verification of Enrollment

A Verification of Enrollment and Attendance is to provide documentation of enrollment and attendance status. This form does not provide information on grades, GPA, or class schedule.

Legal Name*
Phone*
Student Identification Number*
Social Security Number: EXAMPLE xxx-xx-1234*
Expected Graduation Date*
MM slash DD slash YYYY
Semesters to be Verified*
Please indicated which semesters you need to be verified. You may indicate more than one semester. Also, indicate if it is a Spring, Summer, or Fall term followed by the year.
Parent Reference
Please indicate any parental reference with a contact phone number. This is not required to complete the verification.
Who is the Verification being addressed to:*
Mail Verification to:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
FAX Verification to:
Email Verification to:
Please check the box to authorize West Liberty University to complete a Verification of Enrollment.*
This student is the sole individual to request any information regarding enrollment history. CONFIDENTIALITY NOTICE: This verification request, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information or otherwise be protected by law. Any unauthorized review, use, disclosure or distribution is prohibited.
- Yes, I am the student requesting verification of enrollment.
- No, I am not the student requesting verification of enrollment.
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Verification of Enrollment

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