jlh06162011
High School Transcript Request
(Please Note: Complete this form and send to your high school)
I have applied to Davenport University:
□ Please forward a copy of my High School transcript indicating date of graduation.
□ Please forward a copy of my GED test scores with PASS/FAIL date.
Please have all official transcripts for the above named individual mailed directly to:
Davenport University
Registrar’s Office
6191 Kraft Avenue SE
Grand Rapids, MI 49512
866-925-3884
***Please attach this form along with the official transcript * * *
Student’s Name: _____________________________________________________
ID/SSN: ______________________
Maiden Name: ______________________________________________________
Date of Birth: ___________________
Address: ___________________________________________________________
City: _____________________________________________
State: __________
Zip: ___________________________
Home Phone: ______________________________________
Work Phone: ____________________________________
Signature: __________________________________________________________ Date: __________________________
Name of Educational Institution: _________________________________________________________________________
Address: ___________________________________________________________
City: _____________________________________________
State: __________
Zip: ___________________________
Last Date of Attendance: __________________
Enclosed for Transcript Fee: $___________________
