Fillable Transcript Request Form - Howard Payne University printable pdf download

TRANSCRIPT REQUEST FORM

♦ Complete the information requested before printing this form; Sign the printed form; Mail or fax the form to the Registrar’s Office along with

the appropriate payment amount.

♦ Under the Family Educational Rights and Privacy Act (FERPA), a transcript cannot be released without your signature. Due to the signature

requirement, transcript requests cannot be accepted by email. Printed, signed, and scanned request forms attached to an email are acceptable.

Incomplete or Illegible Forms may Delay Processing

Full/Legal Name

: ________________________

________________________

______________________

__________________________________________

Last

First

Middle

Maiden/Former Name(s)

:______________________

______________________

:_____________________

SSN

Date of Birth:

Approximate Last Date of Attendance

Daytime Phone ______________________ Cell Phone ________________________ Email Address __________________________________

Current Mailing Address:

_________________________________________ ______________________________ __________________ _________________

Street

City

State

Zip

SIGNATURE:_________________________________________________________ Date:___________________________________

OFFICIAL TRANSCRIPT REQUEST INFORMATION - $5.00 per official transcript

Number of Official Transcripts Needed:___________________________

Name or Institution to receive the Official Transcript and Full Mailing Address for each Official Transcript to be sent:

________________________________________________________________________________________________________________________

UNOFFICIAL TRANSCRIPT REQUEST INFORMATION - No charge for unofficial transcripts

Students enrolled after 1990 have access to their unofficial transcripts through CampusConnect®.

Students may receive access information by

calling the Registrar's Office at 325-649-8011.

Students may copy unofficial transcripts if multiple copies are needed.

__________________________

Send Unofficial Transcript by:

Mail

Fax - Fax #:____________________ Name of Person Receiving Fax:

Name or Institution to receive the Unofficial Transcript and Full Mailing Address for each Unofficial Transcript to be sent:

________________________________________________________________________________________________________________________

If more space is needed for addresses, please use the back of this form.

♦ Regular Processing Option:_____ Mail: $5.00 per official transcript. Transcript will be processed within 5-7 business days except during

peak times when additional time should be allowed. Transcripts are mailed via regular 1st class U.S. mail

♦ Rush Processing Option: :_____ Mail: $5.00 per official transcript plus $5.00 rush processing fee. With this option, your request will be

processed as quickly as possible and sent via regular 1st class U.S. mail.

Payment may be made by Cash, Check, or Credit/Debit Card. IF PAYING BY CREDIT CARD, THE FOLLOWING INFORMATION MUST BE PROVIDED:

Credit Card Billing Address; including zip code:______________________________________________________________________________

______________________________________________________________________________

Credit Card Number:__________________________________________________________________________________________________

Expiration Date:_______________________________________

3 Digit Security Code (on the back of the card):_______________________

Signature for Credit Card: _________________________________________________________ Date:________________________________

Howard Payne University, Office of the Registrar, 1000 Fisk Street, Brownwood, Texas 76801 • Email: registrar@hputx.edu

Phone: (325) 649-8011 • Fax: (325) 649-8909

Transcript Request Form - Howard Payne University

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