Fillable Form F-046 - Transcript Request Form - Suny Empire State College printable pdf download

For Office Use Only

Transcript Request Form

Payment amount ___________________

IMPORTANT INFORMATION

• Transcripts cannot be released without your handwritten signature.

• Transcripts will not be issued for students or alumni who have outstanding financial obligations to the college.

• Your transcript consists of a degree program (if approved at the time of the transcript request), narrative evaluations

of each successfully completed study for all terms prior to November 2011 and a transcript summary.

• Transcripts are processed in the order in which they are received. Please allow up to two weeks for processing.

During periods of heavy volume (start and end of semester), please allow additional time for processing.

• Official transcripts opened prior to being delivered to a third party might not be considered official.

• We do not produce electronic transcripts.

• The fee for an official transcripts is $5 per copy.

Please print clearly or type

SS # or ID # _____________________________________________________________

Date of birth ______________________

Current full name _____________________________________________________________________________________________

Name while attending__________________________________________________________________________________________

Current mailing address ____________________________________________________

Is this a change of address? q Yes q No

City/State/Zip _______________________________________________________________________________________________

Email address ________________________________________________________________________________________________

Phone number________________________________________________________________________________________________

Transcript(s) will be sent immediately unless otherwise indicated below (select only one)

q Send transcript after degree/certificate is awarded.

q Send transcript after final grades are processed for the ____________________ term

q Send transcript after degree program with advanced standing credit is concurred

Number of transcript(s)

Please indicate the number of transcript(s) you would like for each level (undergraduate or graduate)

Total # of transcripts ______

Undergraduate transcripts ______

Graduate transcripts ______

(Total # of transcripts should equal number of undergraduate and graduate combined)

PAYMENT OPTIONS

q Check payable to SUNY Empire State College

q Money order payable to SUNY Empire State College

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Signature _______________________________________________________________

Date _____________________________

Transcript will not be released without your handwritten signature

Send ______ number of transcripts to the following address:

___________________________________________________

Attach additional pages (for more recipients) if needed.

Mail to: Transcript Request, Office of the Registrar, SUNY Empire State College, 2 Union Ave.,

Saratoga Springs, NY 12866-4390

06102–RC-4

F-046–Rev. 4/2017

Form F-046 - Transcript Request Form - Suny Empire State College

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