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Full-Time Status Letter Request

Page 1 of 2

Put 'N/A' if you do not have a first name.

FAMILY NAME*
FIRST NAME*
MIDDLE NAME
STUDENT NUMBER*
PHONE NUMBER*
E-MAIL ADDRESS*
STREET ADDRESS*
CITY*
STATE*
ZIPCODE*
HOW MANY HOURS ARE YOU

CURRENTLY ENROLLED IN*

Do you want your credit hours listed in the letter* Yes    No   
DEGREE*
MAJOR*
ARE YOU AN IEP STUDENT* Yes    No   
WHEN DID YOU BEGIN AT UCM* FALL    SPRING    SUMMER   
(List Semester & Year)*

Please move to page 2 to complete your request.