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Transcript Request Form: Student Information

This document is a transcript request form for Columbia Southern University. It provides instructions for students to print, complete, sign, and return the form along with the $10 processing fee in order to request that an official transcript be sent to another institution. The form collects student information like name, ID, dates of attendance, and degree information. It also requests payment details and the name and address of where the transcript should be mailed. Processing time for the request is 7-10 business days whether the transcript is issued as official or unofficial.

Uploaded by

Parveen Dagar
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© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
168 views

Transcript Request Form: Student Information

This document is a transcript request form for Columbia Southern University. It provides instructions for students to print, complete, sign, and return the form along with the $10 processing fee in order to request that an official transcript be sent to another institution. The form collects student information like name, ID, dates of attendance, and degree information. It also requests payment details and the name and address of where the transcript should be mailed. Processing time for the request is 7-10 business days whether the transcript is issued as official or unofficial.

Uploaded by

Parveen Dagar
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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TRANSCRIPT REQUEST FORM

21982 University Lane, Orange Beach, AL 36561


251.981.3771 ~ Fax 251.224.0575
[email protected]
CSU must have an original signature to process this request. Students should print the form, complete, sign
and return by fax or mail to the address listed at the top of this form. Official transcripts must be on file for
any transferred courses or they will not be included on the official transcript issued by CSU.
The transcript will be sent as a sealed Official Transcript to the institution or person indicated on this form.
An unofficial transcript may be faxed if indicated on the request form. Please note, the $10.00 transcript
processing fee still applies whether the transcript is issued as Official or Unofficial.
Due to increased requests, the processing time for this request is 7 - 10 business days
(whether issued as official or unofficial).

STUDENT INFORMATION
First:

Name

MI:

Last:

Address Line 1
Address Line 2
City:

State:

Zip:

E-Mail:

Student ID:

Birth Date:

Day Phone

ATTENDANCE
Currently Enrolled Student

Year First Attended:

Degree(s) or Certification Awarded (List below)

Year Last Attended:


Date Graduated:

PAYMENT INFORMATION
1. Financial obligations to Columbia Southern University must be cleared before transcript can be released.
2. The fee is $10.00 for each transcript issued.
3. If using credit card, billing address must be submitted below in order to process payment.
Visa
MasterCard
American Express
Discover
Payment Method:
Personal Check
Money Order
Exp. Date:
Card Number:
Name on card:
Billing address:
City:

State:

Zip:

MAIL TRANSCRIPT TO NAME AND ADDRESS BELOW


If transcripts are to be sent to more than one address, please list names and addresses of recipients on a separate
sheet and attach to this form.
Institution / Student Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:

Students Signature:

State:

Zip:

Date:
Revised 12/2008

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