Enrollment Verification Request Form

Enrollment Verification Request Form
Student Number*
Example: A1234567
Full Name*

First NameLast Name
How Would you like to receive your copy of the verification?*

Mailed to my addressEmailed to me
SUSCC Student E-mail*
example@alabama.edu
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Semester you are requesting verification for:*
Year*
Please upload a copy of your government-issued ID. If the ID is not attached, the request will not be processed. *

Cancelof
Special Notes:
Current Enrollment Information and Pre-Verification Information are subject to change. Enrollment data cannot be confirmed officially until the end of the drop/add period each term.
Signature*

Clear
Should be Empty: