|
NAME: ________________________________________ UH ID:
_______________________ |
|
MAIDEN NAME (If applicable): ______________________________ DATE:
______________ |
| LOCAL ADDRESS:
_____________________________________________________________ |
| I am requesting ________ number of copies for a
letter of verification as follows: |
|
| _____ Status Verification
_____ Grade Verification
_____ Graduation Verification |
| List semester(s) and year for which you need
this information: ______________________________ |
| Special Instructions: |
| _____ Include the University seal
_____ I will pick up on: _____________ |
| _____ Fax to this number:
___________________ _____
Mail to the address listed above |
|
_____ Mail to the following
address: ______________________________________________
______________________________________________
______________________________________________
______________________________________________________________________________ |
|
Section I - Status Verification |
| School in which you are enrolled:
___________________________________________________ |
 Status:
_____ Full-time (Undergraduate: 12 or more credits; Graduate: 9
or more credits) |
_____ Three-quarter
time (UG: 9-11.99 credits; G: depends on program)
|
_____ Half-time (UG: 6-8.99 credits; G: depends on program)
|
_____ Less than half-time (UG: less than 6 credits; G: depends
on program)
|
| Current credit load: _________________
Anticipated date of graduation: _________________ |
|
______________________________________________________________________________ |
|
Section II - Grade Verification |
| Course Code: _____________
Course number: ______________ CRN:
_________________ |
| Course title:
____________________________________ Number of Credits:
_______________ |
| Date completed: ______________
_____ Additional courses listed on back
|
|
_______________________________________________________________________________ |
|
Mail to: University of
Hartford
Student Administrative Services Center
200 Bloomfield Avenue
West Hartford, CT 06117
Please allow 7 to 10
business days for processing. |