HHS - Graduation Verification Form

Please note that processing time is currently as much as 5-7 business days. Thank you for your understanding!

Requestor Name Requestor Name First Last
Organization/School/Institution Name

What organization/school/institution are you with?
Requestor Job Title
Requestor Email
Requestor Phone Requestor Phone - ### - ### ####
Student Information:
Student Name Student Name First Last
Date of Birth Date of Birth / MM / DD YYYY
Request Info:
Purpose of request

Purpose of request Employment School Enrollment
Specific information needed
Reference number

If you'd like us to include a reference number when responding, please include it here.
Web form to complete

If you'd like us to complete this information using your own form, please include it here