Transcript Request Form
~~~~FOR OFFICE USE ONLY ~~~~
Total Amount Paid: _________
Haskell Indian Nations University
On HOLD : ______________
Attn: Registrar's Office Processed by: __________
155 Indian Ave. Issued: ______________
Lawrence, KS 66046-4800 Date Sent: ____________
~ Transcript fee ~ $3.00 per transcript.
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Hold for current semester grades:
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Total number requested: _______
#1- Send Transcript Here: #2 - Send Transcript Here:
#3 - Send Transcript Here: #4 - Send Transcript Here:
~ No outstanding balance.
~ NO PERSONAL CHECKS ACCEPTED
~ Pay at the business office, return receipt to 119 Navarre Hall
Signature: ______________________________
Date of Birth: ______________
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(White Copy: Registrar's) (Yellow Copy: Student's)