Registrar: Verification Request Form

Verification Request Form
Office of the University Registrar
Division of Academic Affairs

1009 Rollins Hall ● Norfolk, VA 23529-0052 ● Telephone: (757) 683-4425 ● Fax: (757) 683-5357 ● Email: [email protected]
Verification Request Form
Note: ODU verifies your enrollment information monthly to the National Student Clearinghouse. Your SSN must be on file for this to occur
Student Full Name Student Full Name * First Middle Last
(First Name, Middle Name or Initital, Last Name)
University/Student ID Number or SSN: *
Must be between 8 and 11 characters. Currently Entered: 0 characters.
Email Address: *
Verification Information

Please check all applicable options:
Please complete the attached form for the below semester (attach form to this request).
List Semester Here: *
Upload a File *

Attach Files
Please provide copies of a verification letter that includes the following information (check all that apply): Present semester enrollment (must be registered) I am participating in the Teacher Research/Graduate Assistantship Program Pre-registration for future semester (must be registered) Full-time/Part-time status Expected Date of Graduation Other
List Pre-Registration Semester Here: *
How many copies? *
Expected Graduation Date:
Other: *
Maximum of 1000 characters allowed. Currently Entered: 0 characters.
Delivery Instructions

Please bring your Photo ID to pick up any verification.
I will pick up this verification. Please contact me when verification is ready. I authorize a third party to pick up my verification for me. Please contact me when verification is ready. Third party must bring his/her photo ID to pick up your verification. Please fax verification to: Please email verification to: Please mail copies to the address below:
Your contact preference once completed: *

Your contact preference once completed: Phone Email
Daytime Phone Daytime Phone * - ### - ### ####

Area Code + Phone Number
Third Party's Name: Third Party's Name: * First Last
Your contact preference once completed: *

Your contact preference once completed: Phone Email
Daytime Phone Daytime Phone * - ### - ### ####

Area Code + Phone Number
Fax Number: Fax Number: * - ### - ### ####
Email Address: *
Number of Copies: *
Address Name: Address Name: * First Last
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Deadline Date (if applicable): Deadline Date (if applicable): / MM / DD YYYY

*Please allow at least 2 business days for processing.
*

I certify under penalty of disciplinary action that the information I have provided is true.
Signature (draw or type) *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
Please allow at least 2 business days for processing.
-- BDMS -- Index to: Correspondence - Records
Upload a File (optional)

Attach Files

	
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Registrar: Verification Request Form

Note: ODU verifies your enrollment information monthly to the National Student Clearinghouse. Your SSN must be on file for this to occur

Verification Information

Delivery Instructions