B-E Enrollment Verification Form

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Please complete this form to request enrollment verification. Once this form is submitted a letter will be generated and available for pickup at the Burlington Edison District Office from 12pm- 4pm the following day, please call to make sure it is ready: (360)757-3311 (the form can also be mailed or emailed to a specified address). If you have any questions please contact Jessica Brown at: jmbrown@be.wednet.edu

Todays Date: *

YYYY

Students Name: *

Students Date of Birth: *

YYYY

Parent/Guardian Name(s): *

Current Address: *

Address While Attending: *

Are there other students in the family that need a letter? *

Yes (If Yes, add below)

Additional Students Name(s):

* First and Last

* Please include Date(s) of Birth

How would you like to receive the letter(s):
*

Next School Day Pickup at District Office, 12pm-4pm (927 E. Fairhaven Avenue, Burlington WA 98233)

Email (Please note email address Below)

United States Postal Service (Please note mailing address if different than listed in Skyward)

Please use the space below to note email/mailing address:

Please use the space below to note Contact Phone Number:
*

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