Southeastern Louisiana University
Office of Records and Registration
Transcript Request Form
(Request is valid for 30 days)
Transcript is to be:
Name and Address of where Transcript is to be mailed:
Picked up by me
Picked up by a designated person (**see name below)
Send via US Mail (please indicate mailing address below)
Number of Copies Requested (Maximum of three per request)
Person, University / College, or Business Name:
Address:
City State
Zip Code:
Student's Information:
Are you an early start student?
Send transcript now? Do you plan to graduate this semester?
OR
Hold transcript for:
Student's Last Name:
Student's First Name
Middle
Initial
.
Last Name Used as a Student (if different):
Social Security Number:
Student ID Number ("W" Number):
Birthday:
Student's Mailing Address:
City: State:
Zip Code:
Student's Phone Number (Day)
Student's Phone Number (Evening)
YES NO
Approximate Dates of
Attendance at Southeastern:
Send electronically (please indicate email address)
Faxed (Unofficial Only) (please indicate fax number)
Email Address
Fax Number (Unofficial Transcipt Only)
YES NO
End of current semester's grades to be posted Posting of degree
Student's Signature: (Required for release of information) DATE
NOTES:
All transcripts mailed to students or picked up by students will be marked "Issued by Student."
Transcripts ordered for pick up MUST be picked up within 30 days. Transcripts not picked up within this time frame will be shredded and a
new request required. Incomplete forms will not be processed. Processing time 7-10 business days.
**Name of designated person to pick up transcript: (Identification is required):
Complete and sign this request form and mail to:
Southeastern's Office of Records and Registration
SLU 10752
Hammond, LA 70402
OR
Fax to:
Southeastern's Office of Records and Registration
(985) 549-5632
YES NO
