Attached Document Request Form | University Registrar

Please use this form to request UREG to process Transfer Report or any third-party form(s) and allow 5-9 business days for completion of your request.

For scholarship: Please complete the Outside Scholarship Self-Reporting Form for the appropriate academic year: https://sfs.virginia.edu/tuition-billing/forms

You will need to select Yes on the question regarding the donor requiring enrollment certification. Once you select yes, you will have the option to attach the form(s).

Student Information

Last Name

First Name

Middle Name

Previous/Maiden Name

Student ID

Computing ID (ex: abc3k)

Phone

Birth Year

Directory Information

The University of Virginia has defined directory information as student name, birth year, major field of study, school of enrollment, location of attendance, full/part-time status, level (graduate, undergraduate, etc.) and year in school, medical residency placement, expected graduation date, participation in officially-recognized activities and sports, dates of attendance, candidacy for degree, degrees, honors, scholarships, and awards received, any unique identifying number created for the purpose of compiling, releasing, or transmitting Directory Information.

To receive any information not included in the previous list, the student must provide the Office of the University Registrar with their signed authorization.

Note: Request will be processed in compliance with the Federal Family Educational Rights and Privacy Act of 1974, as amended

Request Detail

Attachment(s)

Upload requirements

Comment

Delivery Method

Fax

Mail

Email
Email

Fax

Fax
Fax

Mail

Name	Address	Address 2	City	State	ZIP	Country	Operations
Name	Address	Address 2	City	State	ZIP	Country

Release of Information

By checking this box, I authorize the Office of the University Registrar and the Office of the Dean of Students to release any necessary academic or disciplinary information for the purpose of fulfilling this certification request. This information may be sent to me via email, regular mail, or fax, using the contact information I have provided.

Signing & Authorizing

By submitting this form, I authorize the Office of the University Registrar to release any academic information and the Office of the Dean of Students to release any disciplinary information required to fulfill this request for certification. The information may be sent via email, regular mail, and/or faxed to the contact(s) provided.

Signature