Enrollment Certification


*Requestor's Name
(first and last)
 

Student/Alumni Information:

Student ID (7-digit)
*First Name
Middle Name
*Last Name
*Date of Birth  (mm/dd/yyyy)
Daytime Telephone Number
*Email Address
 

Type of Certification:

 
Term Information  
All Terms  
Single Term   Year   Term
Please note if you are requesting this for the current term prior to the drop/add period, your form will be held for processing until then.
Include Previous Degree Earned? Yes
  No
  Not Applicable
 

Send Certification to:

Name
Address, if certification is to be mailed
(US Postal Service)
Fax Number, if certification is to be faxed
Email, if verification is to be emailed

*indicates required field

For questions regarding this form, please contact the University Registrar's Office at registrar@case.edu or 216-368-4310.