Civil Engineer School
Transcript Request Form
PRIVACY ACT STATEMENT: The following information is provided as required by the Privacy Act of 1974 authorized by 10 USC 8012.
In order to process this application, we must ask for a Social Security Account Number if you are a US Citizen. Even though not required, it will help in expediting this
application; however, failure to provide the information will result in the designated agency not receiving transcripts as requested by the student.
elephone: Comm (937) 255-5654 DSN 785-5654
Fax: Comm (937) 255-4645 DSN 785-4645
2950 Hobson Way
WPAFB, OH 45433-7765
Complete and return to the above email or address. If not filling out this form online, make sure that you print legibly.
First Name Last Name Middle Name/Initial Maiden Name or Other Name
SSN or Student ID# Daytime Phone Number Date Of Birth Email Address
Address 2 City State Zip
Please complete the following for EACH course:
Dates course was taken:
Where was course taken?
Was this a seminar?
Note: Any additional information you are able to provide will be of great assistance in processing this request.
Number of transcripts being mailed to the address below:
Address City State Zip
5. Brief Student Comments and Mailing
6. Signature and Date: Transcript request without signatures cannot be processed. Electronically sign and email or ink and
click to sign
click to edit