Kutztown University Transcript – Fill Out and Use This PDF

Please complete this form and allow 2-3 business days after receipt for processing. In the case of high volume, there may be a delay.

Transcripts for students enrolled prior to Fall 1983 may take longer to process, and same day service cannot be guaranteed.

The Registrar’s Office is not responsible for incomplete or incorrect addresses. The University does NOT fax transcripts.

Requests will NOT be honored for a person with financial or other outstanding obligations to the University.

Students are limited to FIVE transcript requests per day.

All transcripts are sent via standard US mail unless a pre-paid envelope is provided.

Transcripts cannot be mailed to a dorm address.

Student’s Name (Please Print): ____________________________________________ Degree(s) Earned: _______________________

Student ID # or Social Security Number: ____________________________________ Date of Birth: __________________________

Dates of Enrollment: From ________ To ________ Phone #: Home ( ) __________________ Cell ( ) _____________________

Address: _______________________________________________ City: ____________________ St: _________ Zip: ___________

Check here if this address constitutes a request to change your permanent address.

Maiden/Former Name: _________________________________________________________________________________________

A copy of a legal document is required to change your name on your transcript. (Marriage license, etc.)

STUDENT’S SIGNATURE ________________________________________________________ Today’s Date _______________

Your signature authorizes, under the Privacy Act, the release of your transcript.

WHEN REQUIRED:

Process immediately.

Process after current semester’s/session’s grades are recorded. Specify semester/session and year _____________________

Process after Degree I am currently pursuing is recorded on my transcript. Specify semester/session and year ____________

I will pick up my transcript(s). _____# of transcripts to pick up

A photo ID is required to pick up transcripts. If someone else will be picking up your transcript(s), please provide that individual’s complete name. Please notify that individual that he/she will be asked to provide a photo ID at the time of pick-up.

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