TRANSCRIPT REQUEST FORM
*** PLEASE BE ADVISED THAT WE DO NOT PROVIDE OFFICIAL ELECTRONIC COPIES. ***
If you need transcripts sent to more than one location, please complete multiple forms. Do not write on
the back of forms. Please allow 5-7 business days for processing.
Student Name: _____________________________________________________Date:_____________
Mercy College Student ID # -or- SSN:________________________ Date of Birth:_________________
Previous Name (if applicable): __________________________________________________________
Number of Copies: Official (free, max 5 per request): ________ Unofficial ($5 each): ________
Mail Transcript to:
Please include ONLY _____ Graduate _____ Undergraduate level of classes with my request.
(Please note that both levels will be included if not specified.)
_____ Currently Enrolled OR _____ Previously Enrolled
Dates of Attendance (mo./year): ______/__________ to ______/__________
Graduation Date, if applicable (mo./year): ______/__________
Hold Transcript Request (check one):
_____ Do not hold request. Send transcript now.
_____ Hold until Grades are posted for (check):
_____ Hold until Degree awarded: Month ______, Year __________, Degree Type _______________
Email to: firstname.lastname@example.org Fax to: Registrar’s Office Mail to: Mercy College
Subject: Transcript Request 914-674-7516 555 Broadway
Dobbs Ferry, NY 10522
FALL WINTER SPRING SUMMER
SEMESTER TRIMESTER QUARTER
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