Verification/Deferment Request Form

Name*
First Last
Student ID Number*
GCU E-mail Address*
Phone Number*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please prepare a letter of verification for me including the following information*
Semester(s) or session(s) to be verified*
Request for Verification Delivery*
- I would like to pick up my Request for Verification (student will be called when Verification Letter is ready for pick up)
- Email (student will be emailed Verification Letter to their GCU email)
- Please mail the letter to the following address
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student Signature*
Date*
MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

Mon 8:30 AM - 4:30 PM

Tue 8:30 AM - 4:30 PM

Wed 8:30 AM - 4:30 PM

Thu 8:30 AM - 4:30 PM

Fri 8:30 AM - 4:30 PM

Sat CLOSED

Sun CLOSED

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