Saint Leo Transcript Request Form – Fill Out and Use This PDF

TRANSCRIPT REQUEST FORM

Saint Leo University

In order for your transcript to be issued, you must provide the following information and have satisfied all financial obligations to the university. There is a charge of $15.00 for each paper transcript requested. An additional charge of $32.00 is due for overnight request(s) delivered within the United States. Overseas shipments are subject to additional fees based on the carriers’ service rates. Payment must accompany request. Credit card orders are accepted, or you may pay by check or money order. Make check or money order payable to SAINT LEO UNIVERSITY. The university will not provide a transcript of transfer credit until successful completion of coursework at Saint Leo University. Fill out one request form for each address to which you are sending copies.

You MUST sign your request. Requests without signatures will not be processed.

Date of Request ___________________________ Number of Copies ___________________

Student ID or last 4 digits of SSN______________________ Date of Birth _____________________

Student’s Last, First, Middle Name (Maiden or Former Name on record, if applicable)

___________________________________________________________________________________

Daytime phone number ____________________________________________________

Email address ____________________________________________________________

Name as it appears on credit card _____________________________________________

Credit Card Number ________________________________________________________

Expiration Date ______________________ Security Code ________________________

Billing Address ______________________________________________________________________

City, State, Zip _______________________________________________________________________

ADDRESS TO SEND TRANSCRIPT TO:

SPECIAL INSTRUCTIONS:

Hold transcript until:Semester/term grades postDegree Conferral Overnight delivery (additional charge of $32.00)

Student Signature ____________________________________________________________________

(Digital signatures are not accepted)

The Family Educational Rights and Privacy Act of 1974 requires written authorization from the student before transcripts can be released.

Return completed transcript request form by mail, fax or email to:

Saint Leo University, Registrar, P.O. Box 6665 MC2278, Saint Leo, FL 33574-6665 Fax: (352) 588-8656 Email: transcripts@saintleo.edu

06/10/2020