Official Use Only
GC ID#: ___________
REQUEST FOR TRANSCRIPT
Last Name____________________________________________
First Name _________________________________
MI __________
Previous/Enrolled Name (if different) _______________________________________________ Date of Birth ____________________________
Check to update address:
Current Address ________________________________________
City ______________________
State __________
Zip _____________
Daytime Phone _________________________ E-mail address ________________________________ Soc. Sec. Number ______________________
PROGRAM(S) ATTENDED AT GRATZ COLLEGE
(Example: Cont. Ed, RTC, BRA, Other, MA Ed, JCHS, etc.)
ARE YOU CURRENTLY ENROLLED? [Y/N] __________
IF YOU ARE NO LONGER ENROLLED, PLEASE INCLUDE: Year of graduation/Separation ____________ Degree Received (if any) _______________
CURRENTLY ENROLLED STUDENTS:
If you are requesting Official transcripts, please specify one or more of the following conditions to insure that your transcript is complete prior to
being sent out. Please be advised that these conditions may cause delays in processing and mailing.
Send now (although some grades may be missing)
Fees
st
Send after __________ semester’s grades are posted
Transcripts Processing (1
transcript)………..…………9.00
__________
Course ID ___________ Section___________ Completion date
Additional transcript (each)………………………….………5.00
Send after graduation has been confirmed (6-8 weeks after commencement)
Express Processing/Walk-ins……….………………..……14.00
Month: _________________ / Year: ____________
Number of Transcripts requested
Shipping Options (in addition to above fees)
Official:
_____
Official – Standard: Up to ten business days……....…Free
Unofficial:
_____
*Unofficial Transcripts free
Official – Express Shipping: Requested by noon……19.99
Total:
_____
Unofficial Standard: Up to ten business days…….…..Free
Mail transcripts to: List additional addresses on reverse, or attach separate page with instructions
________________________________________________
_______________________________________________
________________________________________________
_______________________________________________
________________________________________________
_______________________________________________
•
By signing this form you are authorizing Gratz College to release your transcript as indicated above.
•
Transcript request will not be honored if there is a “HOLD” on the account from the Business Office or Library.
•
The college does not fax transcripts and will not be responsible for transcripts after they are mailed.
For Official Use Only:
Amt. Pd. ________________________ Request Rec’d _______________________ Sent _______________________ By _______________________
Batch Number ________________________________________ Check # __________ Check Date_____________ Hold Y/N __________________
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Student’s signature/Date (required): __________________________________________________________
Date: _______________________
We Accept Visa/MasterCard/Discover/Check/Money Order:
Credit Card Number: ______________________________________________ Expiration Date: _____________________ Security Code _________
Office of Student Records, Gratz College 7605 Old York Road, Melrose Park, PA 19027
Telephone: (215) 635-7306 Fax: (215) 635-7399 Toll free: (800) 475-4635
studentrecords@gratz.edu