"Transcript Request Form - Pennsylvania College of Health Sciences" - Pennsylvania

ADVERTISEMENT
ADVERTISEMENT

Download "Transcript Request Form - Pennsylvania College of Health Sciences" - Pennsylvania

165 times
Rate (4.3 / 5) 8 votes
Pennsylvania College of Health Sciences
Attn: Transcripts
850 Greenfield Rd
Lancaster, Pennsylvania 17601
TRANSCRIPT REQUEST FORM
The Family Educational Rights and Privacy Act of 1974 (FERPA) requires that all transcript requests be in
writing, signed and dated by the person to whom the record belongs. Telephone, faxed, scanned and
email requests WILL NOT be accepted. You can assist us in giving speedy accurate service by providing
complete information.
To obtain a transcript, send a written request that includes the following:
 FULL NAME as it appears on your record. Please include your maiden name, if married, or any
other name used while enrolled at the College
 STUDENT ID NUMBER (Student ID # or Social Security #)
 PROGRAM attended
 DATES OF ATTENDANCE; Years attended, year graduated or a Current Student
 NAME and ADDRESS OF INSTITUTION to which the transcript is to be mailed. Please include
the office to receive the transcript.
 YOUR SIGNATURE AND DATE
After completing request in its entirety, send it to the above address. Please complete one form per
Transcript request.
There is a $5.00 processing fee for all official transcripts (current students may receive 1 free official
transcript per semester). There is no fee for unofficial transcripts. Official transcript fee payment will
be accepted in the form of check or money order. Checks should be made payable to PA College.
We are unable to fax or email transcripts, official or unofficial.
Please Note:
College policy prohibits issuing transcripts to any student who is indebted to the
College. The issuance of partial transcripts is strictly prohibited.
CASH IS NOT ACCEPTED!
Pennsylvania College of Health Sciences
Attn: Transcripts
850 Greenfield Rd
Lancaster, Pennsylvania 17601
TRANSCRIPT REQUEST FORM
The Family Educational Rights and Privacy Act of 1974 (FERPA) requires that all transcript requests be in
writing, signed and dated by the person to whom the record belongs. Telephone, faxed, scanned and
email requests WILL NOT be accepted. You can assist us in giving speedy accurate service by providing
complete information.
To obtain a transcript, send a written request that includes the following:
 FULL NAME as it appears on your record. Please include your maiden name, if married, or any
other name used while enrolled at the College
 STUDENT ID NUMBER (Student ID # or Social Security #)
 PROGRAM attended
 DATES OF ATTENDANCE; Years attended, year graduated or a Current Student
 NAME and ADDRESS OF INSTITUTION to which the transcript is to be mailed. Please include
the office to receive the transcript.
 YOUR SIGNATURE AND DATE
After completing request in its entirety, send it to the above address. Please complete one form per
Transcript request.
There is a $5.00 processing fee for all official transcripts (current students may receive 1 free official
transcript per semester). There is no fee for unofficial transcripts. Official transcript fee payment will
be accepted in the form of check or money order. Checks should be made payable to PA College.
We are unable to fax or email transcripts, official or unofficial.
Please Note:
College policy prohibits issuing transcripts to any student who is indebted to the
College. The issuance of partial transcripts is strictly prohibited.
CASH IS NOT ACCEPTED!
Pennsylvania College of Health Sciences
Attn: Transcripts
850 Greenfield Rd
Lancaster, Pennsylvania 17601
TRANSCRIPT REQUEST FORM
___________________________ ___________________________ _____
______________________________
Student ID # or Social Security # Last Name
MI
First Name
(Required)
Name under which you attended, if different from above._________________________________________________
Your contact number: (_____) _____________________ E-mail address __________________________________
Area code
Name of Program____________________________________________________
Check One
_____ Current Student
_____ Alumni
Year of Graduation __________________
_____ Withdrawn Student
Dates of Attendance _________________
Check one or both
When should transcript be processed?
_____Official Transcript ($5.00 fee)
_____ Now
_____ Hold for current semester’s /module grades
_____Unofficial Transcript
Which semester/module______________
_____ Hold for degree
SEND TO
CHECK here
PICK UP
:
: ____
or
to
Enter Address below
:
(email sent to above address when ready for pick up)
NAME:
________________________________________________________________________________________________
ADDRESS:
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Sample Address Format:
College America
Attn: Mr/Mrs/Dept
123 Anywhere Road
Anywhere, USA 12345
Please sign here for release of transcripts
_______________________________________ Date _____________
OFFICE USE ONLY
Pd $ ________ Date _________
Initials__________
Page of 2