Transcript Request Form
Required Student Signature for Release of Transcripts-
Student’s Signature:_____________________________________________________Date:_____________
By signing this form you authorize the LU Registrar’s Office to send your transcript(s) to the designated person(s) or organization(s) listed above.
Rev: 4/16
Payment- Official transcripts are $10 for the first copy and $1 for each additional copy on the same request (this price
applies to electronic, official transcripts, as well as hard copies of transcripts). Unofficial transcripts are free.
*Expedited Shipping - Additional fee of $20 per mailing address in addition to the transcript fee. USA Street addresses
only. Expedited shipping is not available for international, PO Box or APO addresses.
Submit Completed Form To:
Registrar's Office
1971 University Blvd, MSC Box 710177
Lynchburg, VA 24515
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Name:________________________________________________________________________________________________________________
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Student ID#__________________________ Last Four Digits of SSN: _________________ Birth date: _____________________
Address:________________________________________________________________________________Phone#_____________________
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Send transcripts to: Send transcripts to:
______________________________________________________
______________________________________________________
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______________________________________________________
Number of copies: __________
Expedited Shipping* (optional)
Official transcript(s)
Unofficial transcript(s)
Number of copies: __________
Expedited Shipping*(optional)
Official transcript(s)
Unofficial transcript(s)
Please check here if you serve/served in the U.S. Military
The transcript fee is waived for all military members (active duty, discharged, retired, etc.).
This policy does not apply to military spouses or dependents.
If Expedited shipping is requested, the student must provide payment to cover the Expedited shipping charge.
Payment Information:
Credit Card #: ________________________________________________ Expiration Date: _____________ Billing zip code: _____________
~We also accept payment by check, money order or cash if you mail your request to our office.~
If you prefer to pay over the phone with a credit card, you may call our office at (434) 582-2000 or toll free (888) 632-5551.
Pay by credit card:
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Please be sure to sign the form above before submitting it.
Fax: (434) 582-2187
Email: LUTranscripts@Liberty.edu
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