Education Verification Form
This form should be filled by both the applicant and the University/College registrar together.
Name
First Name Last Name
Social Security Number
Date of Birth
Month Day Year
Please provide information about your highest education level.
School Name
Registrar Office Address
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code
Credits Earned
Degree to be Obtained
I, the applicant, agree with the following statement:
I hereby authorize the company to contact the Institution specified above for employment or Curriculum Vitae to verify my attendance and degree status.
Date
Month Day Year
Date
Signature
Clear
The applicant do not write below this line.
To be completed by the University or College
Please select the applicable one
I certify that above information is correct. The following information is incorrect. The following individual was not a student at our school.
Name
First Name Last Name Title
Date
Month Day Year
Date
Signature
Clear
Should be Empty:

Education Verification Form