Haven University Transcript Form – Fill Out and Use This PDF

TRANSCRIPT REQUEST FORM

OFFICE OF THE REGISTRAR -- LOCK HAVEN UNIVERSITY -- LOCK HAVEN, PA 17745

Completed form may be faxed to 570-484-2734	~ There is no charge for transcripts.
PRINT -- STUDENT’S NAME AND MAILING ADDRESS
	________________________________________________
_______________________________________________________	LHU Student ID # [If ID is not known, indicate SSN – used to
	locate correct record]
_______________________________________________________	________________________________________________
	BIRTHDATE
_______________________________________________________	________________________________________________
	PHONE (HOME)
_______________________________________________________	(____________)__________________________________
	CELL PHONE
_______________________________________________________	_______________________________________________
MAIDEN NAME	ANY OTHER LAST NAME
Email Address ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___	___ ___ ____ ____ ___ ___ ___ ___ ___ ___ ___

(This may be used if there are problems with your request or to notify you of the status of your request if transcript is sent electronically.)

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CURRENTLY ENROLLED AT LHU? ______YES				_______NO (IF NO, DATE LAST ATTENDED ________________)
LHU GRADUATE?		______	YES/YEAR _______		_______		NO
YEAR FIRST ATTENDED LHU	_________

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SEND TRANSCRIPT NOW	_________			HOLD FOR CURRENT GRADES		_________
HOLD FOR GRADUATION CLEARANCE	_________			HOLD FOR GRADE CHANGE	_________

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STUDENT’S SIGNATURE ________________________________________________________DATE_____________

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

OFFICIAL TRANSCRIPTS BEARING THE SEAL OF LHU WILL BE SENT UPON COMPLETION OF THE TRANSCRIPT REQUEST FORM. ALL TRANSCRIPTS WILL BE PROCESSED AS OFFICIAL DOCUMENTS. HOWEVER, IN ORDER TO BE CONSIDERED OFFICIAL BY OTHER COLLEGES/UNIVERSITIES AND PROSPECTIVE EMPLOYERS, THE TRANSCRIPT(S) IS (ARE) TO BE SUBMITTED IN THE SEALED ENVELOPE AS RECEIVED BY THE STUDENT. NORMALLY THIS REQUEST WILL BE PROCESSED WITHIN 2-3 DAYS; HOWEVER, DELAYS MAY OCCUR DURING PEAK PERIODS. SUBMIT A SEPARATE FORM FOR EACH MAILING ADDRESS/ELECTRONIC RECIPIENT. THIS REQUEST WILL BE RETURNED TO YOU UNPROCESSED IF INSUFFICIENT INFORMATION IS PROVIDED OR IF THERE IS A HOLD ON YOUR GRADES FOR FINANCIAL REASONS. STUDENT IS RESPONSIBLE FOR CORRECT AND LEGIBLE INFORMATION.

SEND THIS NUMBER OF TRANSCRIPTS (#) ____ Undergraduate Transcript(s) AND/OR (#) ____ Master’s Program Transcript(s)

DELIVER TO (complete one):

Electronic Recipient :______________________________________________________________________________________

Institution and Office (i.e. Admissions, Graduate Admissions, Registrar, etc)

Name of Recipient: _____________________________________________________________________________________

Recipient’s Email: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ____ ____ ___ ___ ___ ___ ___

Confirm Recipient’s Email: _____________________________________________________________________

US Postal Service (1 stClass Mail)

Fax (Unofficial) - Enter Recipient’s Fax Number (______)_________________