Academic Record Request

Transcript/student records are released only to the student or to an educational institution. You may be asked to submit a formal letter of request. If the record you are requesting is not found in the Archives, you will be notified of other possible locations or referred to other repositories as soon as possible. The suggested fee is $20.00 per transcript or school record.

* Name of Student:
* School/Institution:
* City:
* Years Attended:
* Mother's Maiden Name:
Details:

* Requestor's First name:
* Last name:
Organization/Company:
* Mailing Address:
* City:
* State/Province:
* Zip/Postal code:
Country:
Day Phone:
* E-mail:
* Purpose of Request:

*	I certify I am the above named student or academic institution representative

Fields denoted by an asterisk () are required*

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