Off-Campus Request for Official Transcript
Office of the Registrar - Transcripts, 003 Wilder Tower, University of Memphis, Memphis, TN 38152-3520
* Allow up to 5 business days for processing any transcript request. *
Use this form only when mailing your transcript request. We do not accept FAXed requests or scanned
requests attached to an email.
Name:
Last:
_________________ First:_________________ Middle:_________
Contact Info:
Street Address:
_______________________________________________
City:
________________ State: ________________ Zip: __________
E-mail: _________________________________ Ph: (___) ____-______
U-Number:
____________________ OR Last 4 Digits of SSN: ___________
Birth Date: MM:___DD:___YY:___
Former Names:
__________________________________________________________
Years Attended University of Memphis:
First Yr:
______ Last Yr:______
Check if Appropriate:
Mail transcript now.
I will pick up at your office.
Hold transcript for the current term’s grades. (Info format, ex: Full/Spring/20YY.)
Part of Term: _____________ / Term: _____________ / Year:_____________
Hold transcript for degree. (Info format, ex: BA/Spring/20YY.)
Degree: _____________ / Term: _____________ / Year:_____________
Hold transcript for pending grade change. (Info format, ex: ENGL4501/Spring/20YY.)
CourseID: _____________ / Term: _____________ / Year:_____________
I attended Law School at UofM.
I have taken Continuing Education (CEU) courses and want them included.
I have attached Enclosures that should accompany the transcript.
Release Academic Record & Other Pertinent Information to (Name/Address): [#Copies]:
(Attach additional addresses if necessary.)
[___]
[___]
Signature:
_____________________________________ Date: ____________
An Equal Opportunity/Affirmative Action University
