Student Action Request Form Name* Student ID Social Security Number* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* What is your status?* Currently enrolled No longer enrolled: graduated No longer enrolled: did not graduate What is your current classification?* 1L day student 2L day student 3L day student 4L day student 1L evening student 2L evening student 3L evening student 4L evening student Select the appropriate field for your classification* Full-time student Part-time student Audit student Date of graduation* MM slash DD slash YYYY Last date of attendance* MM slash DD slash YYYY Date of request* MM slash DD slash YYYY Electronic Signature* Please print your name as your signature, authorizing your request(s) found on this form.Personal Information Change RequestYou may skip to the next section if you are not submitting a change to your personal information.Please select all that apply Address change Name change Phone change NEW Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PREVIOUS Name* First Middle Last NEW LEGAL Name* First Middle Last NEW Residential Phone NumberNEW Business Phone NumberNEW Cell Phone NumberAdd/Drop Class RequestYou may skip to the next section if you are not submitting an add/drop request.Term Fall Spring Summer Year Select all that apply add course(s) drop course(s) ADD Course(s)*Course IDCourse TitleSection DROP Course(s)*Course IDCourse TitleSection Transcript RequestYou may skip to the next section if you are not submitting a transcript request.Transcript Policy1.) All transcripts are $5.00 each payable in advance (no charge for bar transcripts); 2.) Transcripts are not issued until all outstanding accounts with AJMLS are paid in full. Please allow three to five business days for processing. Letter of Good Standing - student copy available online.Select all that apply Official copy of transcript (enter number below) Include class rank on transcript Send only after grades are posted Enter number of copies* Company or school name for address #1 Address #1 Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Company or school name for address #2 Address #2 Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Withdrawal RequestYou may skip to the next section if you are not submitting a withdrawal request.Do you wish to withdraw enrollment? Yes No What term do you wish to withdraw from?* Fall Spring Summer Enter year of the term you wish to withdraw from* Reason for withdrawal*Other RequestPlease specify your request:Enrollment VerificationsThe National Student Clearinghouse provides enrollment verifications. Individuals or companies requesting student enrollment information should contact the NSC at www.enrollmentverify.org.