Verification of Good Standing Form for College Officials

To the student: Please complete this form with your personal contact information. When you submit this form, a request will be sent to the email address you provide for the College Official who will verify your status. If you have attended more than one institution since leaving Providence College, you must complete a separate form for each school.

Student Information

Student's Legal Name (last, first middle)

Student's Contact Information

Number and Street

PO Box / Apartment Number

City

State

ZIP Code (5 digits)

Country

Student's Phone

Student's Email

Email address of the College Official who should receive the request to verify the student's good standing [Please double check the email address to ensure that it is accurate. Otherwise, the form will not be routed properly.]