Student Status Certification Form

Students can view their term student status on Vergil/Student Services Online (SSOL).

MS students can request to be certified for Full or Half Time student status if one of the below applies:

• Full Time Requirement: Student is registered for at least 9 credits and at least one credit is a clinical course
• Half Time Requirement: Student is registered for at least 5 credits and at least one credit is a clinical course

DNP students can request to be certified for Full Time student status if the student is taking at least 6 credits with one or more credits in a clinical course.

Students must submit this request by the end of the Change of Program Period for the term they wish to certify. Students will not be certified after the Change of Program Period, and will not be retro-actively certified. This form must be submitted for each semester a student wishes to certify.

First Name

Last Name

Phone Number

UNI

CUIMC Email Address

Birthdate

Program Information

Program Currently Enrolled In:

Student Status Certification Request

I am requesting:

Full-Time Status

Half-Time Status

In the:

Summer Term

Fall Term

Spring Term

Year (ex: 2020)

Total number of Credits enrolled in during the above term?

Courses Information (Must be currently registered in courses during requesting term)

List all Course Numbers, Names, and Amount of Credits (Ex: N8102-Advanced Pharmacology, 3 credits)

Are you registered in a clinical course?

Yes

No

Clinical Course Number, Name, and Credits:

Signature

Full Time status students are automatically enrolled in the Aetna Student Health Insurance Plan. By requesting Full Time status, I realize I will be enrolled and charged for the Aetna Student Health Insurance Plan. Contact the SHS office for more information.

By submitting this form, I request that the Office of Student Affairs certify my student status in the above term.

Electronic Signature: