College Visit Verification Form

This form should be completed by the appropriate personnel at each college you visit. Return this
completed form to the office upon your return to school. REMEMBER, in order for the absence
to be excused, in addition to returning this completed verification form, you must also submit
your request online at counseling.goppca.com/collegevisits
Name _______________________________________________ Grade ___________________
The following section should be completed by the admission personnel of the school you visit:
_____________________________________
Date of Attendance

____________________________________
Name of University

_____________________________________
University Representatives Printed Name

____________________________________
Title/Position

I certify that the above named student attended our college for a preview visit on the above noted
date.
_____________________________________
Signature

____________________________________
Date

Office Use Only

Request Rcvd _________________ Request Appvd _________________ Verification Rcvd _____________