Indicates required field Requestor's Name Student/Alum Information Student ID (7-digit) Name First Name Middle Name Last Name Date of Birth Daytime Telephone Number Email Address Type of Verification Term Information All Terms Single Term Year Term -SELECT-FallSpringSummer If you are requesting this for the current term, please do not submit your request until after Drop/Add ends. Include Previous Degree Earned? Yes No Not Applicable Send Verification to Please select one of the following delivery options. Name Address, if verification is to be mailed Fax Number, if verification is to be faxed Email, if verification is to be emailed For questions regarding this form, please contact the University Registrar's Office at registrar@case.edu or 216-368-4310. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Reset Leave this field blank Save
