College of Arts and Sciences
Office of
the Registrar
Phone 503.768.7335 |
E-mail reg@lclark.edu | www.lclark.edu
Verification Request
Lewis & Clark verifies enrollment for present and past semesters only.
Return the form to the CAS Registrar's Office in person or by email – student signature required.
Name Date
LC ID# Email
Choose one of the following options:
Complete and send the attached form. Specify the form:
Special instructions:
Complete an online form.
Name of the institution/organization that will receive the completed form:
It is the student’s responsibility to know the content of the questions on the form. Your signature on this form authorizes
the Registrar’s Office to provide all information requested including, but not limited to, academic and conduct records.
Send standard enrollment verification. A Standard Enrollment Verification is an official printed form that includes
the student's name, address, DOB, student ID number, semester dates, number of credits, full or part time status, start
term & class level. It is signed by the Registrar and has the official college seal.
Mark below if you need additional information (like cumulative GPA, academic standing, etc.) included.
Specify:
Send official letter on college letterhead.
Information to be included:
DELIVERY:
Hold for pick-up
(must show photo ID at time of pick-up)
Mail to
(please include name of recipient)
Email:
I authorize the Registrar's Office to release my enrollment information and / or other requested information specified above.
I also understand emailing is not a secure form of transmission (if requested).
Signature Date
Must be your actual physical signature. We cannot accept digital stamps or typed “signatures”.
For Registrar’s use only:
Additional requested Yes Attached form completed Completed by:
info included :
N/A Online form completed
