Transcript Request Form

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Transcript Request Form
Registrar’s Office: 303-762-6995, 6399 S. Santa Fe Dr. Littleton, CO. 80120, transcripts@denverseminary.edu, FAX: 303-783-3122
Requests should be sent to the Registrar’s Office by mail, fax, or email. If you have a hold on your account, it must be cleared before
transcripts can be sent.
Student Contact Information:
Student #:
Today’s Date:
Date Last Attended:
__________________________
________________
________________
First Name:
Middle Name:
Last Name:
_________________________
______________________
________________________
Previous Name(s):
Social Security #:
___________________________________________
___________________________
Current Address:
City:
State:
ZIP:
____________________________________________
___________________
_______
_______
Phone #: (
)
-
Email Address:
_______
__________
_______________________________________
Transcript Request Information:
Transcript Recipient Information:
Select Transcript Type:
Send
transcripts to the following address:
_______
Official
Unofficial
Institution or company
Select Delivery Type:
Person and/or Department
Unofficial copy emailed (processed once a week)
Standard ($5.00 processed once a week)
Rush ($15.00 processed within 1 day of receipt)
Street Address
After grades post for ______ semester
After degree is posted
City
State
ZIP
Indicate Number of Transcripts Requesting:
Send
transcripts to the following address:
_______
_______ @ $0.00
-Unofficial Email
_______ @ $5.00
-Standard Mail
Institution or company
_______ @ $15.00 -Rush Mail
$______ Total Cost
Street Address
Transcript requests will not be processed until payment is
received. We accept cash, check or credit. Credit card
City
State
ZIP
payments can be made online at:
Student Signature (required*)
Date
* In accordance with the Family Educational Rights and Privacy Act (FERPA) your signature is required to authorize release of your transcripts.
Special Instructions:
For office
Date Received: _______
Date Paid: _______
Date Mailed: _______
use only
Holds?_______
Amount Paid: $_______
Processor Initials: _______

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