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TRANSCRIPT REQUEST
Name ______________________________________________________________________________
(Print Clearly)
Last First MI Student ID Number
I authorize the release of my academic records to the individual named below.
CONTACT INFORMATION
DATE OF REQUEST
Month Day Year
Name
Address
NUMBER OF COPIES (check appropriate boxes and indicate number)
Telephone
To be picked up ($5 per copy)
Official ________
To be mailed ($5 per copy)
SEND TRANSCRIPTS TO (Print Clearly)
To be express mailed ($25 per copy)
Name
Street
TYPE OF TRANSCRIPT
State Zip
City
Undergraduate
Graduate
Professional
Date of Birth________________________________________________________________
Maiden OR Other Last Name ____________________________________________________
HOLD TRANSCRIPT UNTIL:
Year of Last VCU Graduation ____________________________________________________
End of fall semester
End of spring semester
Dates of Attendance __________________________________________________________
End of summer semester
Special Instructions __________________________________________________________
Posting of degree
End of intersession
STUDENT SIGNATURE__________________________________________________________ DATE___________________________________
(Required for Release of Transcript)
Please Return to the Office of Records and Registration
Monroe Park Campus
1015 Floyd Ave., room 1100
P.O. Box 842520
Richmond, VA 23284-2520
Transcripts are sent via US Postal Service first class mail, express mail or can be picked up by the requester. Only five transcripts can be requested
per day. Allow five days for processing. The charge for transcripts is $5 per copy for first class mail or pick up and $25 per copy for express mail.
Payment should be mailed with your request form as a check or money order payable to VCU. Please do not send cash. When delivering a request in
person, please pay the cashier before submitting.
For Records and Registration use only:
Date Sent ____________________
Office of Records and Registration • Grace E. Harris Hall • 1015 Floyd Ave., 1st Floor • P.O. Box 842520 • Richmond, VA 23284-2520 • www.rar.vcu.edu
