Fillable Transcript Request Form - University Of Richmond printable pdf download

OFFICIAL TRANSCRIPT REQUEST FORM

Students/Alumni receive up to 80 free transcripts.* Financial obligations (holds) to the University must be cleared before requests can be honored. Only UR transcripts may be

requested or released. Outgoing transcripts may not be faxed. Regarding electronic transcripts, the content of the official transcript is converted into a PDF document

and delivered to the recipient via eSCRIP-SAFE™, the authorized delivery agent selected by the University of Richmond.

***Please allow up to 5 business days processing time.***

PLEASE TYPE DIRECTLY ONTO THE FORM HERE

or PRINT CLEARLY. Press the 'Tab' key to move to the next field.

___________________________________________________________________________

____________________________________________________________________________

Last Name

First

Middle

Name used at UR if changed

or XXX - XX -

_________________________________

________________________

___________________________________________________________________________

Student UR ID Number (current students MUST use their UR ID) or last 4 digits of SSN

Address

___________________________________________________________________________

____________________________________________________________________________

City

Zip Code

Date of Birth (MM/DD/YYYY format)

(abbreviate)

(________)__________________________________________________________________

____________________________________________________________________________

Daytime Phone Number

Email Address

____Current Student

Degree Received (degree/date format) if applicable: __________________________

____ Not Current Student

Last Attended UR _________________

Use this address information to update my permanent records.

_____

PLEASE HOLD REQUEST UNTIL GRADES ARE RECEIVED FOR (OPTIONAL)  Fall  Spring  Summer ________________ (Specify term)

 Please hold for degree conferral

 Please hold for grade change

I H EREBY AUTHORIZE THE UNIVERSITY OF RICHMOND TO RELEASE MY ACADEMIC TRANSCRIPT BY WAY OF:

 Pick up at the Office of the University Registrar

Issue to Student in Sealed Envelope (All transcripts must be picked up within 60 days.)



Picture ID required for pick up.

Signed release required if transcript will be picked up by someone other than student.



Transcripts issued directly to a current student will bear the notation "Issued to Student" on "Issued to Student in Sealed Envelope" as requested.



 Send ELECTRONIC transcript via eSCRIP-SAFE™ to the recipient in the lower section.

Electronic option available for students entering in 1992 to present.



Please see Registrar’s Office website ( ) for full details regarding electronic transcripts.



 Mail paper transcript to the recipient in the lower section.

Write clearly as delays may occur due to incomplete or illegible addresses.



One paper copy will be mailed unless other quantity is indicated. Use address blocks on the next page for additional recipients.



Purpose of Disclosure (REQUIRED):

Grad/Law School

Study Abroad

Other Education

Internship

Employment/Licensure

Self

***FOR PAPER TRANSCRIPTS*** RECIPIENT INFORMATION

No. of Paper Copies (First 80 transcripts are FREE*) _________

Attention/Business

*AFTER 80 transcripts, the fee is $1 per transcript picked up or $2

__________________________________________________________________

Name

per transcript mailed, requested in sealed envelope, or sent

electronically. Law students applying to clerkships may apply for

Address Line 1

__________________________________________________________________

a fee waiver through the Law School Career Services Office.

Address Line 2

__________________________________________________________________

Print out, sign, and return the completed request

form either in person, by fax, or by email (as a

signed and scanned PDF).

City

________________________________ State __________________ Zip Code _____________

Fax to: (804) 287-6578

Mail to:

***FOR ELECTRONIC TRANSCRIPTS*** RECIPIENT INFORMATION

Office of the University Registrar

28 Westhampton Way

___________________________________________________ State (required) _______

University of Richmond, VA 23173

Recipient

Email to: registrar@richmond.edu

____________________________________________________________ _______

Email Address

***ONLY FOR ELECTRONIC TRANSCRIPTS TO AMCAS (American Medical College Application Services)***

Both fields are REQUIRED: AAMC ID (8 digits) ____________________________ AMCAS Transcript ID (7 digits) __________________

***ONLY FOR ELECTRONIC TRANSCRIPTS TO LSAC (Law School Admissions Council)***

Field is REQUIRED: LSAC ID (L +8 digits) ____________________________

I understand that my official transcript will be delivered via the method selected and that any holds currently on my record will prevent release of my transcript.

(Privacy Act: All requests require an original signature of the student. Requests without a signature will not be processed.)

__________________________________________________________________________________________________________________________________________________________

***Student Physical Signature REQUIRED. Forms with any type of electronic, stamped, or imaged signature will not be accepted.***

Date

(Complete next page ONLY if additional recipients are requested.)

4/29/2015