ENROLLMENT VERIFICATION FORM |
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| Mail to: UNC at Pembroke Office of the Registrar P.O. Box 1510 Pembroke, NC 28372 |
or | Fax: 910-521-6328 |
| Request
Date: |
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| Name: |
Banner ID: |
| Place an "x" beside the requested information: | ||
| UNCP Degree Awarded |
Major Field of Study |
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| Dates of Attendance |
Currently Registered at UNCP |
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The
following Release of Confidential Information requires the
student's written consent: (OPTIONAL) |
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| Academic Standing |
Comments |
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| Birth Date |
Degree Pursuing |
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| Classification |
Overall GPA |
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| Name and Address of Recipient | Name and Fax Number of Recipient | |
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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. |
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| Student Signature | Date |
This publication is available in alternative formats upon request.
Please contact Disability Support Services, DF Lowry Building, 521-6695.
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