Official Transcript Request Form
Please print clearly and provide all of the information requested. Form is processed within 2-3 business days. Transcripts prior to 1991 may take
longer to process. Any omission of information may delay the processing of this request. $5.00 fee per official copy of transcript.
Today’s Date_______________________________________________________ Student ID#_____________________________________________________________
Date of Birth___________________________________________________________________________________________________________________________________
Name__________________________________________________________________________________________________________________________________________
Last
First
Middle Initial
Former or Maiden Name___________________________________________
Daytime Telephone________________________________________________
Current Mailing Address:
Student Program:
Street_________________________________________________________________
Undergraduate
City___________________________________________________________________
Dates of Attendance:
State_________________________________Zip_____________________________
From________________________________To_____________________________
Did you graduate from Emmanuel?
No
Graduate
Both
Non-degree
Yes If yes, when?___________________________________________________________________
All fields are required. If these are not filled, there may be a delay in processing your request.
Send #________ transcript(s) to the following address:
Unofficial
Official
Institution or Company_____________________________________________________________________________________________________________
Person and/or Department________________________________________________________________________________________________________
Street_________________________________________________________________________________________________________________________________
City__________________________________________________________ State_________________________________Zip______________________________
Send #________ transcript(s) to the following address:
Unofficial
Official
Institution or Company_____________________________________________________________________________________________________________
Person and/or Department________________________________________________________________________________________________________
Street_________________________________________________________________________________________________________________________________
City__________________________________________________________ State_________________________________Zip______________________________
Please check any special requests or handling: (check all that apply)
Pick up
Hold for current final semester grades (will be processed at the conclusion of the semester)
Hold until degree is posted
Hold for grade change
Other_____________________________________________________
I authorize Emmanuel College to release the information indicated to the above listed address(es).
Student Signature (required)_____________________________________________________________________________________Date______________________
Registrar Use Only:
Amount Paid:__________________ Staff Initials: __________________