Read Microsoft Word - Enrollment Request Form text version

REQUEST FORM

VERIFICATION OF ENROLLMENT

Date: _______________ I herby authorize Xavier University School of Medicine to release my enrollment information for the following term(s): Fall __________ Spring __________ Summer __________ Year(s) _________

Address or fax number to which the letter should be sent: ATTN: _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ Special Instructions: ___________________________________________________________________ ______________________________________________________________________________

Student Name: ___________________________________________________________________

Student Signature: _______________________________________________________________

Submit request to the office of the Registrar. Allow 710 business days for processing.

Use this form to request a letter verifying the student's enrollment in Xavier University School of Medicine. The letter list: student's full name, academic term for which the letter is being generated, terms dates, student's status (FullTime / Part Time), student's division (PreMed / Basic Sciences), anticipated graduation date.

This information will not be released without the student's signature. Some institutions provide alternate paperwork. These forms may be submitted in lieu of the Letter of Verification. Enrollment letters will not be issued unless the student is in good financial standings and up to date on payments. Verification of enrollment may only be completed for the term of present progress or past terms. We cannot verify future enrollment.

Xavier Admissions Aruba, LLC / North American Representative Office / Xavier University School of Medicine 1400 Old Country Road Suite C109 / Westbury, NY 11590 / OFFICE (516) 3332224 / Fax (516) 3338151

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Microsoft Word - Enrollment Request Form

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