"Transcript Request Form - Logos Christian College and Graduate Schools"

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TRANSCRIPT REQUEST FORM
To request an official transcript of all courses you have previously completed with LOGOS Christian
College and Graduate Schools, please fax to 904-527-3581 ONLY if paying by credit card; or
include a check or money order payable to LOGOS Christian College and mail to:
LCC&GS Attn: Registrar
6620 Southpoint Drive South Suite #302
Jacksonville, FL 32216
Phone: (800) 776-0127 Fax: (904) 527-3581
A receipt for your payment will be mailed to your address below. Should you have questions, please call
(800) 776-0127.
Note: All financial obligations must be met before transcript(s) will be released. The cost for each
official transcript is $8.00. Most colleges, universities or employers prefer an official or original
transcript to be mailed directly to them. Please include a contact name or department when requesting a
transcript.
Student Information
Last Name: ___________________First Name: ___________________M.I./Maiden Name: __________________
Former Name:
S.S. #:
Date(s) of Attendance:
Date of Birth:
Degree Year:
Street:
City:
State:
Zip:
Current Phone:
________ Current Cell: ______________________________________
Email:
________________________________________
Would you like a transcript sent directly to you?
Yes
No
Send Transcript to: (If different from above address)
Name of Institution:
Attn:
Street:
City:
State:
Zip:
(Fill out only if requesting more than one transcript)
Name of Institution:
Attn:
Street:
City:
State: ________ Zip Code:
__________________
Signature (REQUIRED):
Date:
Method of Payment:
No. Of Transcripts:
Cash $
Check $
Credit Card $
A c c o u n t N o :
Exp. Date:
Credit Card Signature:
V: Code: ___ ___ ___ (back of card)
TRANSCRIPT REQUEST FORM
To request an official transcript of all courses you have previously completed with LOGOS Christian
College and Graduate Schools, please fax to 904-527-3581 ONLY if paying by credit card; or
include a check or money order payable to LOGOS Christian College and mail to:
LCC&GS Attn: Registrar
6620 Southpoint Drive South Suite #302
Jacksonville, FL 32216
Phone: (800) 776-0127 Fax: (904) 527-3581
A receipt for your payment will be mailed to your address below. Should you have questions, please call
(800) 776-0127.
Note: All financial obligations must be met before transcript(s) will be released. The cost for each
official transcript is $8.00. Most colleges, universities or employers prefer an official or original
transcript to be mailed directly to them. Please include a contact name or department when requesting a
transcript.
Student Information
Last Name: ___________________First Name: ___________________M.I./Maiden Name: __________________
Former Name:
S.S. #:
Date(s) of Attendance:
Date of Birth:
Degree Year:
Street:
City:
State:
Zip:
Current Phone:
________ Current Cell: ______________________________________
Email:
________________________________________
Would you like a transcript sent directly to you?
Yes
No
Send Transcript to: (If different from above address)
Name of Institution:
Attn:
Street:
City:
State:
Zip:
(Fill out only if requesting more than one transcript)
Name of Institution:
Attn:
Street:
City:
State: ________ Zip Code:
__________________
Signature (REQUIRED):
Date:
Method of Payment:
No. Of Transcripts:
Cash $
Check $
Credit Card $
A c c o u n t N o :
Exp. Date:
Credit Card Signature:
V: Code: ___ ___ ___ (back of card)