University of the Virgin Islands
Enrollment Verification Form Rev 5/04/2020 Access and Enrollment Services UNIVE RSITY OF THE VI RGIN I SLANDS STUDENT ENROLLMENT VERIFICATION REQUEST FORM Instructions: 1. Complete the form below to request parts of your academic record be verified to outside institutions. 2. Email the completed form to the Office of the Registrar at registrar@uvi.edu 3. Please complete one form for each request. 4. Requests are typically processed in 2 to 3 business days. Student Name: __________________________________ Maiden Name (s): _____________________ Student ID: _____________________________________ Contact Phone: ________________________ Date of Birth : __________________________________ Date Requested: _______________________ Email Address:___________________________________________________________________________ Please send a verification of my academic record via: Email Address Name: ____________________________________________________________ Email Address: _____________________________________________________ Parent Name/Signature ______________________________________________________ …
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Enrollment Verification Form Rev 5/04/2020 Access and Enrollment Services UNIVE RSITY OF THE VI RGIN I SLANDS STUDENT ENROLLMENT VERIFICATION REQUEST FORM Instructions: 1. Complete the form below to request parts of your academic record be verified to outside institutions. 2. Email the completed form to the Office of the Registrar at registrar@uvi.edu 3. Please complete one form for each request. 4. Requests are typically processed in 2 to 3 business days. Student Name: __________________________________ Maiden Name (s): _____________________ Student ID: _____________________________________ Contact Phone: ________________________ Date of Birth : __________________________________ Date Requested: _______________________ Email Address:___________________________________________________________________________ Please send a verification of my academic record via: Email Address Name: ____________________________________________________________ Email Address: _____________________________________________________ Parent Name/Signature __________________________________________________________________ (Note: if student is under age and making request on behalf of the student) Student Signature____________________________________________________________________ Some of these items are considered confidential information and require a student signature. Please check below the appropriate boxes on your request: Indicate semester to be verified: □ spring □ fall □ Matriculation Date (start Date) □ Anticipated/Graduation Date □ Dates of Attendance □ Full-time/part-time status □ Level (undergraduate, graduate, etc.) □ Status (freshman, sophomore, junior, senior, etc.) □ GPA (grade point average) □ Current Credit Hours □ Never Attended Note: The Family Educational Rights and Privacy Act (20 U.S.C. § 1232g; 34 CFR Part 99), as revised, states (a) An educational agency or institution may disclose personally identifiable information from an education record of a student without the written consent of the parent of the student or the eligible student if (1) The disclosure is to other school officials, including teachers, within the agency or institution has determined to have legitimate educational interests. (2) The disclosure is to officials of another school or school system in which the student seeks or intends to enroll. SIGN SIGN