Form Instructions

Please follow the listed steps below to complete and submit the available forms.
  1. Complete the requested form information, date and type your full name as your signature and click 'Email Form to Admissions' button at the bottom of the form.
    Note: Required field titles are in red.
  2. Repeat above step until submission is accepted with no validation prompts.
 
Contact Information
*Enter as xxx-xxx-xxxx
7 Digit Student ID Required
Enrollment Verification & Authorization to Release Information
I hereby give consent to Germanna Community College to release information to the Company/Organization/Person listed below. This form is authorizing a one-time release of information. It does not grant permanent access to your records beyond this request. If you would like for a specific person to have access to your records beyond this request, you may sign a FERPA Release Form granting this permission.

Please complete one of the following pick-up methods:
  • Complete if you would like to pick up the letter. You will receive a phone call when your request is ready. Please bring a picture I.D. with you. Note: If you would like to have someone else pick up the form, please indicate their name and phone number in the following fields:
    Enter as xxx-xxx-xxxx
  • Please indicate the campus which you would like to pick up the verification:
  • Complete if you would like the letter to be faxed or email:
    Enter as xxx-xxx-xxxx
    Enter valid email address
  • Complete if would like the letter to be mailed to you or a third party requesting information (if applicable):
Enrollment verifications already include full/part-time status, dates of attendance, and amount of credits. If requesting the graduation date and/or previous semesters a date and the terms must be indicated by the student in order to process the request. If requesting additional information, please check the appropriate box below:
GPA
Anticipated Graduation Date:
Enter as MM/YYYY
Please check which semester(s) you are requesting verification for:
Student Signature Date Required
Typed Signature is Required