Request for Certification
 
 

Name:

Student ID: Date ______________

Telephone: Email:

Expected Graduation Year:  ____________ Signature________________________________

***By signing this form, I am authorizing the Office of the University Registrar to provide any information necessary to complete this request.  This information is to be released directly to me or mailed to the address listed below.

Directory Information:  The University has determined that the following is directory information: name, local and home address, university email address, phone number, major, dates of enrollment, anticipated graduation, and degrees conferred.  To receive any information not included in the list above, the student must provide the Office of the University Registrar with his/her signed consent.

Note:  This request will be processed in compliance with the Federal Family Educational Rights and Privacy Act of 1974 as amended.

PART II: Information Requested

Please provide written certification of the following information: 

Enrollment for the Current Term Other (please specify):
Pre-Registration for Next Term
Information for DMV
Current Cumulative (GPA)

PART III:  Please note:  The University is not able to offer fax service for certification. 

I will pick up this certification in 2-5 business days from today.
Please mail the form to:
 
 
 

Rev: 5/6/06
PO Box 6904 | Radford, VA 24142 - Fax: 540.831.6642