University Transcript Request Form – Fill Out and Use

REQUEST FOR

ACADEMIC TRANSCRIPT

In accordance with the Family Rights and Privacy Act (FERPA), academic transcripts will be provided upon receipt of a signed, written request form or letter. Requests which are submitted in person will require a photo ID of the student whose transcript is being requested. All transcript holds must be resolved before the transcript can be delivered. *Please allow three business days for processing except for during peak periods at the beginning/end of a term when additional processing time may be necessary. Handwritten Signature Required.

Today’s Date (Month/Day/Year) __________________ CNU ID Number (if known):__________________________

(Social Security Number [optional and voluntary for use with historical records only]): __________________________

Student’s Full Name: _____________________________________________________________________________

(Last)(First)(MI)(Maiden, if applicable)

Other name(s) while attending CNU (if different):______________________________________________________

Date of Birth: ______-________-______ Email Address: ________________________________________________

MonthDayYear

Address: ________________________________________________________________________________________

Street Address	City	State	Zip
Year(s) of Attendance: ____--____ Phone: (	) ________________ Cell Phone: (	)____________________

Additional Information

I am, or may consider, transferring to _______________________________________________________________

(Name of university or college)

I am not returning to CNU for the following reason(s):
Academics	Finances	Family Obligations	Graduation from CNU	Relocation
Personal	Medical	Employment
Did not offer the following major: ____________________________________________________________
Other: __________________________________________________________________________________

	Mailing/Delivery Instructions
Mail	_____ # of copies OFFICIAL transcript(s) to address provided at the top of this request form.
	AND / OR Mail to Third Party
Mail	_____# of copies OFFICIAL transcript(s) to the below address (include complete address).

Name/Organization:__________________________________________________________________________

Attn:_______________________________________________________________________________________

Street Address:______________________________________________________________________________

P.O. Box Number: __________ - or - Apt Number: _________ - or - Suite Number: _____________________

City:________________________________________ State:___________ ZIP: _________________________

Fax UNOFFICIAL transcript to: (	)___________________ Attn:__________________________________
Hold for pick-up _____# of copies	(Transcripts are available within 3 business days*; photo ID required).

SIGNATURE OF STUDENT

__________________________________________________________________________________________________

(Student’s Signature)	Handwritten Signature Required – No Electronic Signature	(Date)

Mail, scan & email, fax, or hand deliver signed request to:

Christopher Newport University, Attn: Office of the Registrar, 1 Avenue of the Arts, Newport News, VA 23606

Email: register@cnu.edu

Fax Number: (757) 594-7711