Form Ga-697-811 - Official Transcript Request - Online And Off-Campus Students - Florida Institute Of Technology

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OFFICIAL TRANSCRIPT REQUEST

Office of Graduate Admissions

Online Learning & Off-Campus Programs

APPLICANT: Complete and mail this form directly to EACH college or university* you have attended. Please make certain that you include the

appropriate transcript fee. This may prevent any delay in the processing of this transcript. (Reproduce this request form as needed.)

ADDRESSEE INSTITUTION: Please forward an official transcript of my record along with this form to Florida Institute of Technology,

Online Learning & Off-Campus Programs, 150 West University Boulevard, Bldg. 406, Melbourne, FL 32901-6975.

Student ID Number ___________________________________________________________________Date________________________________

Student Name ___________________________________________________________________________________________________________

Last

First

Middle

Maiden

Current Mailing Address ___________________________________________________________________________________________________

City _______________________________________________________________________ State_____________ ZIP________________________

Telephone ___________________________________________________________ Date of Birth (Month/Year) ________________________________

College or University Attended ______________________________________________________________________________________________

Mailing Address __________________________________________________________________________________________________________

City _______________________________________________________________________ State_____________ ZIP________________________

Dates of Attendance __________________________ to__________________________

(Month/Year)

Degree Conferred (if applicable)

Associate ____________________________________________________________________________Date________________________________

Baccalaureate ________________________________________________________________________Date________________________________

Master’s _____________________________________________________________________________Date________________________________

Doctorate ___________________________________________________________________________Date________________________________

Student Signature ____________________________________________________________________Date________________________________

PLEASE NOTE: You must sign this request for your university to honor your transcript request.

*It is necessary for Florida Tech to receive transcripts from each college or university you have attended, despite the fact that courses taken at one university may be listed on the transcript of another

university. Graduate Admissions Online Learning & Off-Campus programs will obtain transcripts for former Florida Tech students.

Florida Institute of Technology

Office Graduate Admissions, Online Learning & Off-Campus Programs

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150 West University Boulevard, Bldg. 406, Melbourne, FL 32901-6975

(321) 674-8263

gradadm-olocp@fit.edu

GA-697-811

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