LSU Carrol L. Herring
Fire and Emergency Training Institute
Request For Individual Transcript
Name First Middle Last
Social Security Number Date of Birth
Mailing address
City State Zip
Telephone (W) (H) (Cell) (Fax)
Email: _______________________________________________________________________________
List all Fire Departments and/or Companies worked for when training was received.
Time Frame: From To
.
***We keep records through 1995. For
any records prior to 1995, please
check with your department.
Signature
There is a $10.00 charge per transcript, and the fee will not be reimbursed to you if no
information is found. Also, there is a $10.00 charge for duplicate/replacement
transcripts. Please remit payment along with this transcript request and allow 2 – 3
weeks for processing. If you are a military veteran, please call for pricing.
METHOD OF PAYMENT
Check/Money Order (Payable to LSU FETI)
Credit/Debit Card
Please return form and payment to:
LSU Carrol L. Herring
Fire & Emergency Training Institute
6868 Nicholson Dr.
Baton Rouge, LA 70820
Telephone: 225-334-6300
1-800-256-3473
Fax: 225-334-6341
EMAIL: cmelancon@lsu.edu Revised 6/25/2015
* For security purposes, we will contact you via
phone to obtain card information. Please
provide the following contact information:
Contact Name: _________________________
Contact Phone Number:
__________________
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