TRANSCRIPT REQUEST
Updated: 7/30/10
Print this form - complete entire form
Send to:
Registrar, Sacred
7335 S Hwy 100, P.O. Box429,
Hales Corners, WI 53130-0429
Fax to:
Registrar (414-529-6999)
NAME:_____________________________________________________________
SHST ID# or
SS#:_____________________________________________________
TELEPHONE: Day_______________________ Evening
______________________
EMAIL: ญ____________________________________________________________
CURRENT ADDRESS:
_________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
SIGNATURE:
________________________________________________________
DATE:
_____________________________________________________________
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)
(Official transcripts are sent directly to
another institution or place of employment only)
(Student copies are not considered official)
________________________________________
_______________________________________
________________________________________
_______________________________________
________________________________________
_______________________________________
________________________________________
_______________________________________
If
additional addresses are to be included, please use the back of this form.
FEES:
-
$5
each for regular service.
-
$25
each for rush service (processed upon arrival).
-
$50 each
for 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 _________/__________ Security Code ______
Name on Card (please print)________________________________________________
Signature ______________________________________________ญญ________________