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Enrollment Verification Form

Please print and return the completed form to:

Verification Department
112 Shields Building
University Park, PA 16802-1271

Fax: 814-863-1929

Third-Party Verifiers should not use this request form. Please visit the National Student Clearinghouse website to make a verification request.

Please print and return the completed form to:
Verification Department
112 Shields Building
University Park, PA 16802-1271
Fax: 814-863-1929

Third-Party Verifiers should not use this request form. Please visit the National Student Clearinghouse website to make a verification request.

Identification

Please enter your name.
(mm/dd/yyyy)
Please enter your date of birth.
9-digit Penn State ID number
Please enter your PSU ID.
*Only enter your SSN if you do not provide your PSU ID number.
Please include area code
Please enter your daytime phone number.
Please enter a valid email address.

The following information will be verified: Name; Enrollment Status; Date(s) of attendance (past, current, future); Major(s); Degree(s) Conferred; Current Enrolled Degree(s); Expected Completion Date of Academic Program; Student ID.

Note: The enrollment verification reports all completed or in progress degree programs.

*Enrollment Verifications are Available Free of Charge
Please enter the number of verifications requested.

Mailing Options

At this time, all verifications will be delivered via the U.S. Postal service.

Address Where Enrollment Verification is to Be Mailed

Please enter the name of the person or organization to send verification.
Please enter street address.
Please enter city.
Please enter zip code or postal code.

Requestor Information

Please enter your name.

Please review your entries on this form. If all information is entered correctly, please print, sign, and submit the form to the address at the top.

Requestor Signature

Requestor Signature: _________________________________________________

Date: ____________________________

Requestor Signature: _______________________________________ Date: __________________________

Note: We do not include Social Security numbers on the verification.

Last Revised: 8/24/20