"Transcript Request Form - Emi Independent Study Program"

Transcript Request Form - Emi Independent Study Program is a 1-page legal document that was released by the U.S. Department of Homeland Security - Federal Emergency Management Agency on January 29, 2018 and used nation-wide.

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EMI Independent Study Program
Transcript Request Form
A transcript of your Independent Study course completions will be emailed to you (the student), and sent by
postal mail to any Institutions you indicate below. Please type or write your information legibly. Please allow
10 business days for delivery via U.S. Mail.
*If you are requesting transcripts for a large number of students, please contact our office at 301-447-1200
or
Independent.Study@fema.dhs.gov
for additional completion verification options.
Student Name
:
(required)
Address
:
(required)
City, State & Zip Code
:
(required)
Phone Number:
Email Address
(required):
Social Security Number OR
:
FEMA Student ID (SID)
(1 required)
Please see our website at
https://training.fema.gov/is/privacystatement.aspx
for information on why the ssn is required.
*Student Signature
(required):
*By signing this form you grant permission for the FEMA Independent Study program to release your information to the
designated third party organizations or agencies indicated below.
*Only you (the student) can authorize the release of your training record(s).
Institutions to receive Official Transcripts(s):
*As the requestor, you automatically receive a student copy of your transcript via email. Official transcripts are printed,
sealed and mailed via the US Postal Service. Please allow 10 business days for delivery.
Institution Name
(required):
Attention to
(required):
Address
(required):
City, State & Zip Code
(required):
Institution Name
(required):
Attention to
(required):
Address
(required):
City, State & Zip Code
(required):
Submit your request to:
National Emergency Training Center
EMI Independent Study Program
Independent.Study@FEMA.DHS.gov
Fax to: (301) 447-1201
16825 South Seton Avenue
Emmitsburg, MD 21727-8998
Rev 01/29/2018
EMI Independent Study Program
Transcript Request Form
A transcript of your Independent Study course completions will be emailed to you (the student), and sent by
postal mail to any Institutions you indicate below. Please type or write your information legibly. Please allow
10 business days for delivery via U.S. Mail.
*If you are requesting transcripts for a large number of students, please contact our office at 301-447-1200
or
Independent.Study@fema.dhs.gov
for additional completion verification options.
Student Name
:
(required)
Address
:
(required)
City, State & Zip Code
:
(required)
Phone Number:
Email Address
(required):
Social Security Number OR
:
FEMA Student ID (SID)
(1 required)
Please see our website at
https://training.fema.gov/is/privacystatement.aspx
for information on why the ssn is required.
*Student Signature
(required):
*By signing this form you grant permission for the FEMA Independent Study program to release your information to the
designated third party organizations or agencies indicated below.
*Only you (the student) can authorize the release of your training record(s).
Institutions to receive Official Transcripts(s):
*As the requestor, you automatically receive a student copy of your transcript via email. Official transcripts are printed,
sealed and mailed via the US Postal Service. Please allow 10 business days for delivery.
Institution Name
(required):
Attention to
(required):
Address
(required):
City, State & Zip Code
(required):
Institution Name
(required):
Attention to
(required):
Address
(required):
City, State & Zip Code
(required):
Submit your request to:
National Emergency Training Center
EMI Independent Study Program
Independent.Study@FEMA.DHS.gov
Fax to: (301) 447-1201
16825 South Seton Avenue
Emmitsburg, MD 21727-8998
Rev 01/29/2018