Good Standing, Enrollment Verification, & Graduation Verification Requests

Student Name (Last, First)*

Last NameFirst Name

UIW Identification Number (Student PIDM)*

Student's Phone Number*

Please enter a valid phone number.

Student's UIW Email Address*

Confirmation Email

Select Student's Current UIWSOM Program*

DOMBSIncoming DO Learner

Select DO Classification*

OMS-IOMS-IIOMS-IIIOMS-IV

*Once processed, Ms. Davidson will automatically receive Letters of Good Standing for UIWSOM Student Orgs*

*Once processed, Enrollment Services will upload your Letter of Good Standing to the VSLO system*

If applicable, upload form that needs to be completed

Items Needed*

Please list any additional information and/or special instructions needed to process your request (i.e. letter needs to be signed by a particular representative)

Who should the letter be addressed to?

Where should the completed letter/form be emailed?*

MeOther

(Hidden so data will not be lost) Where should the completed letter/form be sent?

By submitting this request, you authorize UIWSOM to verify and release information regarding your standing and any additional data specifically requested.