TRANSCRIPT REQUEST
Print this form - complete entire form
Send to:
Registrar, Sacred
7335 S Hwy 100,P.O. Box429, Hales Corners,
WI 53130-0429
NAME:_____________________________________________________________
SHST ID# or
SS#:_____________________________________________________
TELEPHONE: Day_______________________ Evening
______________________
EMAIL: ญ____________________________________________________________
CURRENT ADDRESS: _________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
SIGNATURE: ________________________________________________________
DATE:
_____________________________________________________________
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If
you were enrolled under any other name (maiden, religious, etc.) or have a name
change,
please
indicate other name below.
___________________________________________________________________________
Attended from ___________________ญญญญ_ to _________________________________
Degree/Year: MDiv __________ MA _________ Certificate _________ Other___________
Send Transcripts to: (Name, Address, City, State, Zip required)
________________________________________
_______________________________________
________________________________________
_______________________________________
________________________________________
_______________________________________
________________________________________
_______________________________________
If
additional addresses are to be included, please use the back of this form.
FEES:
-
$5
each for regular service.
-
$10
each for rush service (processed within 24 hrs) using U.S. Post Office.
-
$15
each for rush request using FEDEX overnight delivery within the U.S
-
$20
each for rush request using FEDEX overnight delivery outside the
Total Due:
# of Transcripts
requested ___________
X Fee $__________ =
$___________
Payment
in the form of:
___ Check enclosed Check amount $__________ Check # __________
___ Credit Card: ___MasterCard ___Visa
Card
# ________/__________/__________/__________
Exp.
Date _________/__________ 3-digit Security Code __________
Name on Card (please print)________________________________________________
Signature _________________________________________________