Transcript Request Form
Registrar’s Office
• Please complete this form and allow 2-3 business days after receipt for processing. In cases of high volume, there may be a delay.
• There is no charge for transcripts.
• Transcripts for students enrolled prior to Fall 1983 may take longer to process and electronic transcript processing is unavailable.
• The Registrar’s Office is not responsible for incomplete or incorrect addresses. This form will be returned to you IF you have not
signed the request or if there is insufficient information.
• Requests will NOT be honored for a person with a hold on their account as a result of financial or other outstanding obligations
to the University.
• Paper transcripts are sent via standard US mail, unless a pre-paid envelope is provided.
• Transcript will be rendered “unofficial” if opened by someone other than the intended recipient.
• Transcripts will NOT be issued to a third party without written consent of the student. Photo ID must be shown when picked up.
• Transcripts cannot be mailed to a dorm address. The University does not fax transcripts to students.
STUDENT INFORMATION
Student Name _______________________________________________________________Student ID: ________________________________
Home Phone ___________________________ Cell Phone ___________________________ Date of Birth ____/_____/_________
Home Address ___________________________________________________ City____________________ State____ Zip _________________
Maiden/Former Name:
_________________________________________
A copy of a legal document is required to change your name on your transcript. (Marriage license, etc.) A NAME CHANGE FORM MUST ALSO BE COMPLETED.
Email Address: ________________________________________
Date of last attendance (Semester/Year): Have you completed your degree? ( ) Yes ( ) No
TRANSCRIPT REQUEST INFORMATION
Number of Transcripts: ________
Transcript Career: Bachelor’s (Undergraduate) Master’s (Graduate)
Transcript Type: Official Unofficial
Transcript Processing: Immediate Processing After Grades are posted (Current Students ONLY)
After Degree is Conferred (Recent Graduates)
Printed Transcript (Choose 1 Delivery Method)
I will pick up transcript (Photo ID required)
Another individual is picking up my transcript (Photo ID required);
Full name of individual: __________________________________
Transcript sent by Mail
Recipient:_______________________________________________
Address ________________________________________________
City ____________________________State ______ ZIP _________
Emailed/Electronic Transcript: Official ONLY
Recipient Name:________________________________
E
mail Address: ________________________________
Student’s Signature: Today’s Date:
Attn.: Registrar’s Office, P.O. Box 730, Kutztown, PA 19530
Phone: (610) 683-4485 Fax: (610) 683-1586 Email: regoffice@kutztown.edu
R
eason for Request: _____________________________________________________________________________________________________
