Letter of Good Standing/Enrollment Verification

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NOTE:  Upon submitting this form, you will be given the option to pay online, mail a check, or pay at the business office.  The fee is $7.00 per student copy or official copy.  Only requests approved by the Business Office will be released.  An unofficial letter of good standing or enrollment verification letter may be faxed for a $10.00 fee, non-refundable and payable in advance.  There is a minimum 24-hour waiting period before a Letter of Good Standing or Enrollment Verification Letter will be released.  Business Office “Holds” must be removed within 30 days of the date of this request; this request will expire after 30 days from the date of this request.

* Indicates required field.

 

Student's First Name: *
Student's Last Name ; *
Student's Middle Name:
Student's Maiden Name:
   
Belhaven ID#
Social Security Number: *
Date of Birth:
   
Home Phone Number: *
Alternate Phone Number: *
   
Current Mailing Street Address: *
City: *
State: *
Zip: *
   
Is student currently enrolled at Belhaven? Yes    No *
If No, give last date enrolled at Belhaven:
Campus Box Number (if resident student):
   
Chose One: * I will PICK UP my Letter of Good Standing/Enrollment Verification  (Note: Letters are held no longer than 30 days from date of request.  Request will have to be resubmitted after the 30-day period.)
Mail the Letter of Good Standing/Enrollment Verification to the address above.
Mail the Letter of Good Standing/Enrollment Verification to the address below.
  Street Address:
  City:
  State:
  Zip:
   
Method of Payment: Credit Card (Credit card payment can be made through a secure server once this form has been submitted.) If paying by credit card and the name on the credit card is NOT the name of the student, please list both names so payment can be matched up.
                Student name: 
      Name on credit card: 

Cash (The Business Office must receive payment FIRST before the letter of good standing is submitted to the Registrar's Office.  A transcript request will not be processed until payment is received.)

Money Order (The Business Office must receive payment FIRST before the letter of good standing is submitted to the Registrar's Office.  A letter will not be processed until payment is received.)

Check (The Business Office must receive payment FIRST before the letter of good standing is submitted to the Registrar's Office.  A transcript request will not be processed until payment is received. Also, if you are paying by check/cash, note that there is a minimum two week waiting period before transcript requests will be released to the Registrar's Office.)
   
Comments:
   
Applicant's Legal Signature: *
(Type full name)
   
Today's Date: *
   
Agreed acts as your signature: Yes    No *

Print a copy of this form for your records before pressing "submit."

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