Wagner College Transcript Request Form

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WAGNER COLLEGE
TRANSCRIPT REQUEST FORM
Please read the following instructions:
If you are thinking of leaving Wagner before completing your degree, you must meet with an advisor in Center
of Academic and Career Engagement in the Union. This must be done in order to release your transcript.
A transcript will not be issued if you have an unpaid balance. Please contact the Bursar’s Office at 718-390-3112
or
student.accounts@wagner.edu
with questions regarding balances.
Each official transcript costs $10. The transcript request form must be accompanied by confirmation of payment
which can be sent via email, fax or mail.
Online payments must be made with a credit card. Go to:
Please Print:
____________________ ________________________ __________
(Last name)
(First name)
(Middle initial)
______________________________________________________________ ___________________________ _____________ _____________
(Street)
(City)
(State)
(Zip Code)
____________ _______________________________________ _________________________________________________________________
(Area code)
(Telephone Number)
(Email)
Student ID #__________________ OR Social Security Number ___ ___ ___ - ___ ___ - ___ ___ ___ ___
Birth Date _____________________
Name while in attendance _____________________________________
Transcript request:
Fee:
$10.00 each (Official)
# requested ______
Undergraduate or Graduate Transcript ______________
Dates Enrolled: From (Month/Year) _____________ To (Month/Year) _______________
Degree Awarded on (Month/Year) _______________
Payment Confirmation Number ___________________________
Signature _____________________________ Date _____________________
When do you want your transcript sent? (Allow up to 5 business days to process)
Now, with current information _____
Hold for final grades _____
Hold until Degree awarded _____
How do you want your transcript delivered? Hold for in-person pick-up ______
Mail to the address below ______
Send Transcript To:
(PRINT clearly, attach additional addresses if needed)
_____________________________________
For office use only:
Date Received
__________
_____________________________________
Date Sent
__________
_____________________________________
Receipt Sent
__________
Initial
__________
Amount Rec’d
__________
Office of the Registrar
One Campus Road, Staten Island, NY 10301
Email: registrar@wagner.edu
Phone: 718-390-3173
FAX: 718-390-3344

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