__________________
Official Transcript Request Form
MAIL REQUEST OR SUBMIT IN PERSON TO: Outgoing Transcripts, 6000 J Street, Sacramento, CA 95819-6056
Official Transcript Fees (7-business day processing, not including mail time)
$8.00 per transcript
Rush Fees (3-business day processing, not including mail time)
$8 per transcript + PLUS $15 flat fee
1 Rush transcript = $23
2 Rush transcript = $31
3 Rush transcript = $39
All Records
$15.00 per set. Unofficial, photocopied transcripts which Sac State has on file from other schools.
Includes an unofficial copy of Sac State academic transcript (FOR PERSONAL USE ONLY)
Your request will be returned to you and not processed if:
• There is a hold on your record • Full payment is not enclosed • Writing is illegible • Form is incomplete
STUDENT INFORMATION (PLEASE PRINT IN BLUE OR BLACK INK)
Name_____________________________________________________ Student ID #/SSN__________________________________________
Last
First
MI
Address_____________________________________________________________Former Name(s)__________________________________
City______________________________________State________________Zip_____________Email_________________________________
Phone _____________________________Alt Phone __________________________Date of Birth___________________________________
Month
Day
Year
Are you currently enrolled? (Circle One)
Yes
No
Last Semester/Year of attendance at Sac State: _______________________________Term of Graduation: _____________________________
REASON FOR TRANSCRIPT REQUEST (Please check all that apply):
Student Transfer
Scholarship
Military
Grad School / Professional School
Employment
Personal/Other
Please check all that apply:
Transcript Fees (
I would like to pick-up my transcripts (Photo ID required
TRANSCRIPT FEES ARE NON-REFUNDABLE):
upon pick-up)
Hold for current grades_____________(Semester/Year)
______ Official Transcripts at $8.00 each =_______
Hold for degree posting_____________(Semester/Year)
Rush my order for an additional $15.00 fee
Hold for grade change from ____to_____
______ set of All Records at $15.00 each
Course/Year___________
$________
Total fees included:
Hold for additional credit from___________________
Other special instructions _________________________
Please mail transcript(s) to the following address(s):
Please print additional addresses on a separate sheet of paper and attach to this form.
□ Include form with transcript
□ Include form with transcript
____ # of Copies to:
____ # of Copies to:
STUDENT SIGNATURE (REQUIRED) ___________________________________________ DATE_______________
OFFICE USE ONLY: Holds Cleared __________ Sac State Requests ________ $________ A/R Requests _____ $ _____ Rush Service $ ______ Grand Total $________
Check #/Amt _______ / _______ Rcd Date/Initials _______ / ______ Date Verified/Initials _______/______Date Sent/Initials ________/ _______
Rev 03/13