Enrollment Verification

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Once you complete this form, Southeastern University will verify your enrollment in regard to your full time or part time status or whether you ever attended our institution. If you need additional information, please list exactly what you need in the Special Instructions box.

PLEASE NOTE: If you will be requesting enrollment verification for medical/dental insurance or car insurance/good student discount, you will be required to submit the company name and policy/account number. If you have loan deferment documents or scholarship documents you need to submit, please attach them to this form (PDF format only). Please gather all necessary documents BEFORE beginning this form.

Have you ever been a student at Southeastern University?*

SEU Student ID #:*

Full Legal Name*

First name MIddle name Last name

Please provide your name as it appears on official government documents. Failure to do so may delay the processing of your request.

Email*

A confirmation email will be sent to this address.

Phone*

Date of birth:*

Are you a U.S. citizen?*

Last 4 digits of Social Security Number*

Last 4 digits of Social Security Number

Required for verification.

Verification Details

List school year(s) you would like to verify:*

Example: 2019-2020

Select each semester(s) you would like to verify (*Please be aware that we can only provide historical and current enrollment).*

Fall

Spring

Summer

Types

Loan Deferment
Scholarship
Medical/Dental Insurance
Car Insurance/Good Student Discount
Other

Fees

Order Fee ($4 each): Requests will be processed in 3-5 business days plus shipping time if delivery selected is mail. Loan deferment and scholarship are complimentary if requested as a standard order.

Delivery Method

How should we send your enrollment verification?*

What email should we send your enrollment verification to?*

Enter Email Confirm Email

To whose "attention" should we send the fax?*

First name Last name

What fax number should we send your enrollment verification to?*

Who should we mail the document to?*

First name Last name

What address should we send your enrollment verification to?*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Standard Order

Choose type of verification (standard order):*

Insurance Info

Company Name*

Policy/Account Number*

Final Details

Upload PDF documents for loan deferment or scholarship (if applicable)

Drop files here or

Max. file size: 1 MB.

Special instructions (optional)

Records Consent

In accordance with the Family Educational Rights and Privacy Act (FERPA), SEU will not release non-directory information from my educational records without my consent, except in specific circumstances in accordance with law. I hereby request, give permission, authorize, and direct SEU to discuss with and release the specified portions of my educational records to the following permitted recipients. I understand the information may be released orally or in the form of written records. While this form authorizes SEU to release education records to third parties, it does not obligate SEU to do so. SEU reserves the right to review and respond to requests for release of education records on a case-by-case basis. Dates of attendance are considered directory information and can be shared with third parties without student consent. Grade point average for good student criteria requires student/alumni consent.

Confirmation of Consent*

By checking this box, I am confirming that I am the student/former student represented on this form. I hereby give SEU consent to release my records in accordance with the request on this form.

Payment Info

Total

Credit Card Info

Credit Card

Card Details

Cardholder Name

Signature*

By checking this box, I'm confirming that the information provided on this form is accurate and complete to the best of my knowledge.

Phone

This field is for validation purposes and should be left unchanged.

Please note: If you need verification of your anticipated graduation date, request an Enrollment Verification through Southeastern University’s Office of the Registrar.

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