REQUEST FORM
Transcript or Duplicate Degree
Office use only Rec: _________ Paid: _________ Receipt #: _________ Date processed: _________Address verified in CampusVue__________
Last Name:
First Middle/Maiden
Name used while attending:
Social Security #
Address:
Daytime Phone:
City Zip
Did you graduate from ECPI?
Yes No
Which campus did you attend?
If you did not graduate, please provide dates of ECPI attendance (approximate):
This form must be printed and include an original signature for processing.
Year
Student Signature (Required for all requests)
To:
(mm/dd/yyyy)
Date:
Date of birth:
(mm/dd/yyyy)
STUDENT INFORMATION
ZipState
City
AddressCompany/School Name
I attest that the above information is correct.
Print this form and mail or deliver the original to your local campus with payment:
Name
SUBMIT THIS FORM
From:
University Administration 5555 Greenwich Road, Virginia Beach, VA 23462 Registrar@ecpi.edu www.ecpi.edu Rev. 10/13/2014
(mm/dd/yyyy) (mm/dd/yyyy)
5555 Greenwich Road
Virginia Beach, VA 23462
1001 Omni Blvd #100
Newport News, VA 23606
10021 Balls Ford Road, #100
Manassas, VA 20109
800 Moorefield Park Drive
Richmond, VA 23236
4305 Cox Road
Glen Allen, VA 23060
7802 Airport Center Drive
Greensboro, NC 27409
4800 Airport Center Parkway #100
Charlotte, NC 28208
124 Floyd Smith Drive
Charlotte, NC 28262
4101 Doie Cope Road
Raleigh, NC 27613
1001 Keys Drive #100
Greenville, SC 29615
7410 Northside Drive #100
North Charleston, SC 29420
250 Berryhill Road #300
Columbia, SC 29210-6467
School of Health Science
2809 Emerywood Pkwy Suite 400
Richmond, VA 23294
School of Health Science
5501 Greenwich Road #100
Virginia Beach, VA 23462
Virginia Beach Online
5555 Greenwich Road Suite 510
Virginia Beach, VA 23462
State
NCPACE Students:
Attn: Students Records Coordinator
5555 Greenwich Road
Virginia Beach, VA 23462
TRANSCRIPT REQUEST INFORMATION
DUPLICATE DEGREE REQUEST INFORMATION
I request a duplicate degree/diploma ($20 fee). Degrees/diplomas can only be sent to the graduate and take 4-6 weeks to process (no expedited orders).
Total amount due $
DO NOT MAIL CASH.
School of Culinary Arts
2428 Almeda Ave Suite 106
Norfolk, VA 23513
School of Health Science
1001 Omni Blvd #100
Newport News, VA 23606
School of Health Science
800 Moorefield Park Drive
Richmond, VA 23236
Name
Company/School Name Address
City State
Zip
PAYMENT INFORMATION
($5 per transcript/normal processing; $10 per transcript for expedited processing; $20 for duplicate degree/diploma).
to me at the address above. to the individual(s) below.
Normal (7-10 business days).for $5.00 OR
Expedited (3-5 business days). for $10.00.
I request that an official transcript be sent:
Process type requested This is a non-refundable, per copy fee.
5234 Airport Road
Roanoke, VA 24012
To make an online payment, please visit: http://www.ecpi.edu/services/transcript-requests/
email
Make checks payable to "ECPI University"
