OFFICE OF THE REGISTRAR
THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

ENROLLMENT VERIFICATION FORM

Directions: Please print, complete and return to the Office of the Registrar.

 

Request Date:  
Name: Student ID:
     
Place an "x" beside the requested information:
UNCP Degree Awarded   Major Field of Study
Dates of Attendance   Currently Registered at UNCP
     
     
The following Release of Confidential Information requires the student's written consent:
Academic Standing   Comments
Anticipated Graduation Date (MMYYYY)   Current Status (ex. FT/PT)
Birth Date   Degree Pursuing
Classification   Overall GPA
     
     
     
     
Name and Address of Recipient   Name and Fax Number of Recipient
     
 
 
 
 
The Family Educational Rights & Privacy Act of 1974, Public Law 93-380, Section 483 requires the written consent of the student before any information, other than directory, can be releases. By my signature on this form, I am requesting that the Office of the Registrar furnish the checked information to the recipient listed.
Student Signature (Required)

 

Please return completed form to:

Office of the Registrar
PO Box 1510
Pembroke, NC 28372-1510

Office Location: Lumbee Hall, Room 133

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