Transcript Request Form

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TRANSCRIPT REQUEST FORM
SENT TO
R&R CMD, NYARNG
ATTN: ___________________________, OSM,
WATERVLIET ARSENAL
1 BUFFINGTON STREET, (BUILDING 120)
WATERVLIET, NY 12189-4050
ATTENTION:
Registrar’s Office (COLLEGE NAME)
______________________________________________________
STREET _____________________________________________
CITY _______________ STATE ___ ZIP CODE ___________
FROM:
NAME _____________________________________________________
SOCIAL SECURITY NUMBER ______________________________
STREET ___________________________________________________
CITY ____________________ STATE ____ ZIP CODE ___________
TELEPHONE NUMBER ____________________________________
YEAR GRADUATED/ATTENDED ___________________________
RELEASE OF INFORMATION STATEMENT:
I, the undersigned, hereby give permission to release and mail the
following information to the New York Army National Guard (address
above):
I need __1___ true copies of my transcripts.
I need _____ true copies of my diploma (If language on
transcript(s) or diploma(s) is not English, please send a
translation).
Please make sure the college seal is affixed to these copies. I have
enclosed the appropriate transcript(s) fees with this request. Thank you
very much.
Sincerely,
____________________
____________________
Date: ______________

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