"Official Transcript Request Form - University of Connecticut" - Connecticut

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Download "Official Transcript Request Form - University of Connecticut" - Connecticut

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233 Glenbrook Road, U-4077
Storrs, CT 06269-4077
Phone: 860-486-3331 Fax: 860-486-0062
Email: registrar@uconn.edu
OFFICE OF THE REGISTRAR
Official Transcript Request Form
Return to Registrar’s Office at Storrs campus. Note: Your transcript cannot be released if there is a hold on your account.
Student’s Current Name:
Last
First
M
If you have attended the University of Connecticut under another name(s), please indicate below:
Date of Birth (required):
Student ID (if known):
and/or NetID (if known):
Phone:
Email:
Dates of Attendance: First semester attended:
Last semester attended:
I would like to request an official transcript be sent to the following recipient(s):
Name and Address of Recipient #1:
Number of Copies to this Recipient:
Name and Address of Recipient #2:
Number of Copies to this Recipient:
I authorize the University of Connecticut to release my transcripts to the recipient named on this form.
Signature:
Date:
(Handwritten signature required, we cannot accept a digital or typed signature)
FOR OFFICIAL USE ONLY
Holds/Problems:
Notified
Ready to Process
Name Letter Included
Forms Included
Name Letter
Forms Copied
Reviewed by
Date
Processed by
Date
registrar.uconn.edu
233 Glenbrook Road, U-4077
Storrs, CT 06269-4077
Phone: 860-486-3331 Fax: 860-486-0062
Email: registrar@uconn.edu
OFFICE OF THE REGISTRAR
Official Transcript Request Form
Return to Registrar’s Office at Storrs campus. Note: Your transcript cannot be released if there is a hold on your account.
Student’s Current Name:
Last
First
M
If you have attended the University of Connecticut under another name(s), please indicate below:
Date of Birth (required):
Student ID (if known):
and/or NetID (if known):
Phone:
Email:
Dates of Attendance: First semester attended:
Last semester attended:
I would like to request an official transcript be sent to the following recipient(s):
Name and Address of Recipient #1:
Number of Copies to this Recipient:
Name and Address of Recipient #2:
Number of Copies to this Recipient:
I authorize the University of Connecticut to release my transcripts to the recipient named on this form.
Signature:
Date:
(Handwritten signature required, we cannot accept a digital or typed signature)
FOR OFFICIAL USE ONLY
Holds/Problems:
Notified
Ready to Process
Name Letter Included
Forms Included
Name Letter
Forms Copied
Reviewed by
Date
Processed by
Date
registrar.uconn.edu