Request For Transcripts Form
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1Request for Transcripts
CURRENT MAILING ADDRESS
U of R Student ID Number
Last or Family Name
First Name
Middle Name
Previous Name(s)
Birthdate DD/MM/YYYY
Address - Apartment #, Street, Box #
E-Mail Address
City or Town
Prov / State
Country
Postal / Zip Code
Telephone
PLEASE NOTE
COURIER FEES
** OUTSTANDING FEES WILL PREVENT TRANSCRIPTS FROM BEING ISSUED **
$ 6.00 within Regina
• Incomplete information may DELAY OR PREVENT this request form being processed
$19.00 within Canada
• Transcripts require five (5) WORKING DAYS to process
$36.00 to the United States
• Only 5 transcripts will be issued per semester
All other destinations will be
• Currently there is NO FEE for transcripts
at current Fed Ex rates.
• Transcripts cannot be faxed or emailed
Fees are subject to change
• If you require a NAME CHANGE on your transcripts you must contact the Registrar's Office
• Transcripts will not be released to a third party without your written authorization
I WILL PICK UP MY TRANSCRIPTS
No. of
Copies
Photo identification is required to pick up transcripts
Transcripts will only be held for 3 months
SEND TRANSCRIPTS TO:
Mailing Instructions
Name
No. of
q
Regular Mail - No Charge
Copies
q
Courier - Transcripts can NOT be couriered to a
Address
PO Box number
Recipient Phone # ____________________
q
Current Record
q
Hold for Final FALL (Sept.-Dec.) grades
q
Hold for Final WINTER (Jan.-Apr.) grades
q
Hold for Final SPRING/SUMMER (May-Aug.) grades
q
City or Town
Province/State
Postal/Zip Code
Country
Hold for Degree to be conferred
Name
q
No. of
Regular Mail - No Charge
Copies
q
Courier - Transcripts can NOT be couriered to a
Address
PO Box number
Recipient Phone # ____________________
q
Current Record
q
Hold for Final FALL (Sept.-Dec.) grades
q
Hold for Final WINTER (Jan.-Apr.) grades
q
Hold for Final SPRING/SUMMER (May-Aug.) grades
q
City or Town
Province/State
Postal/Zip Code
Country
Hold for Degree to be conferred
PAYMENT FOR COURIERED TRANSCRIPTS ONLY
q
Total Amount $
____________________________________
CASH
For Office Use Only
q
Name on Credit Card
____________________________________
DEBIT
Amount Paid ____________________
q
AMX
Credit Card Number
Exp. Date
Received By ____________________
q
VISA
q
Date Received __________________
MC
Receipt Number__________________
Card Holder Signature ____________________________________
SIGNATURES
I hereby authorize the release of my University of Regina Academic Records.
Student Signature
X _________________________________________________
Date _______________________________________
Verification of Pick Up
Student Signature
X _________________________________________________
Date _______________________________________
Registrars Office ▪ 3737 Wascana Parkway ▪ Regina SK S4S 0A2 Canada
Website:
Phone: (306) 585-4172 ▪ Fax: (306)-585-5203 ▪ E-mail: uofr.transcripts@uregina.ca
Revised Nov. 17/11
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