Official Transcript Request

Please fill in your information below.

* denotes required information.

Name you attend under/Maiden Name, at Park and Address
* First Name  
Maiden/Alternative Name
Middle Name
* Last Name  
* Address  
* City  
* State  
* Zip/Postal Code

Student Information
Student ID  
* Social Security Number (If you do not have one, type N/A)  
Last Date Attendance (Ex. Spring 2003)
Did you graduate?
If yes, when?
* Which campus did/do you attend?
Type of Transcript
A seperate request is needed for each type of transcript
Sending the transcript

Address to send to
* Location for shipping
Shipping Method:
Once it is processed which MAY
take 3-5 business days

1. USPS Express Mail requires that you provide a good street address or PO box address and phone number of recipient.
2. Fed Ex and DHL require that you provide a good street address and phone number of recipient.
Number of Copies  $10.00 per copy
* Send To
Attention of
* Street Address  
* City  
* State  
Zip/Postal Code
Phone Number

If you have additional addresses for transcripts to be sent to, check this box

Credit/Debit Card Information
It is $10.00 charge for each official transcript, which will be combined as one charge on your credit card.  The amount
will be calculated and displayed when you submit this form. (Official transcripts being sent directly to the student will have the envelope stamped

Extra Notes, Information or Questions

Please Re-Enter your name and give your birthday for Verification that you agree to all of these
facts being true to the best of your knowledge and belief, which is the equivalent of your signature.
Also, please include your e-mail address and telephone number so we may contact you if we have a problem.
* Name  
* Birthday  
* Telephone  
* E-mail (One Address only)