Fillable TRANSCRIPT REQUEST FORM (Hanover College)

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TRANSCRIPT REQUEST FORM (Hanover College)

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TRANSCRIPT REQUEST FORM
Office of the Registrar ◆ 517 Ball Drive ◆ Hanover, IN 47243
PHONE: (812) 866-7051 ◆ FAX: (812) 866 -7054
Today’s Date: _______________ (Please allow 2-3 business days for processing)
Name: _______________________________ Student ID or Social Security Number: ____________
Home Address: ____________________________________________________________________
Email: _______________________________ Phone Number _________________________
For each official transcript requested, there is a fee of $6.00. There is no charge for unofficial
copies. Any student whose college account is on hold at the time of processing will not be
issued a transcript.
PICK UP (Please bring photo ID when picking up transcript)
FAX NUMBER (unofficial) ___________________________________________________________
MAILING ADDRESS _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
I hereby give my written consent and authorize Hanover College to release my academic records as
noted.
Signature: _____________________________________________ Date: ________________
(Transcript cannot be released without signature.)
OFFICE USE ONLY
PAYMENT TYPE CASH CHECK #_________ MONEY ORDER
Date Processed: _________________ Processed By: ____________ Accepted By: _________
Quantity Ordered
Official
____________
Hold Transcript For:
Grades: ___________
(Term)
Graduation: _____
Attendance Dates: ________________________ Graduation Year: ____________________
Name Used During Attendance (if different): ___________________________________________
Quantity Ordered
Unofficial
____________
Total Cost
$_______
Reason for Request
__ Transfer
__ Graduate School
__ Scholarship
__ Other
MAILING ADDRESS 2 _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
MAILING ADDRESS 3 _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
MAILING ADDRESS 4 _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
MAILING ADDRESS 5 _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Hold Transcript For:
Grades: ___________
(Term)
Graduation: _____
Hold Transcript For:
Grades: ___________
(Term)
Graduation: _____
Hold Transcript For:
Grades: ___________
(Term)
Graduation: _____
Hold Transcript For:
Grades: ___________
(Term)
Graduation: _____
Reason for Request
__ Transfer
__ Graduate School
__ Scholarship
__ Other
Reason for Request
__ Transfer
__ Graduate School
__ Scholarship
__ Other
Reason for Request
__ Transfer
__ Graduate School
__ Scholarship
__ Other
Reason for Request
__ Transfer
__ Graduate School
__ Scholarship
__ Other
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Completed 21 August 2020

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