College of Staten Island
 The City University of New York
 
Clearinghouse Enrollment Audit Form
Complete this form to address a enrollment reporting issue.
We will investigate the matter and contact you via email you provided.
*Indicates required field
Last Name*
Date of Birth*
- - (DD-MM-YYYY)
First Name*
Middle Name
Have you ever had your name changed? *
Yes       No
If you had your name changed, what was your former name?
First Name*
Last Name*
Email*
What was your last semester of attendance at the College of Staten Island? *
  
Number of credits you were registered for *
 
What issue are you having? *
 

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