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University Registrar

Enrollment Certification Form

Enrollment Certification Form

*Requestor's Name
(first and last)
 

Student/Alum 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
​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 Certification to:

Please select one of the following delivery options.
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.


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* Required Fields