Transcript Request Form

*Indicates Required Field

Last Name:*	First Name:*	Middle Name:*	Maiden Name:

Date of Birth(m/d/yr):*	Student ID or NetID:	Daytime Phone:*
/ /		- -

Current Street Address:*	City:*	State:*	Zip Code:*

There is no charge for Transcripts

You have accessed the online version of the transcript request form, which requires your signature. You must fax, mail or hand deliver a printed and signed copy of this form to the Registrar's Office for processing.

Dates of attendance:

Processing Options:	Place the Transcript in a signed and sealed envelope.

Delivery Method:*	Credit Card #:	Exp:
There is a charge for FedEx delivery	FedEx Account #:

Number of Copies:*

Fax #:

Attn:

If faxing, please also provide a mailing address in the "Send To:" field. If an address is not provided, your transcript will NOT be faxed.
Send To:		The address provided above





		*A separate form is required for each unique address.

Signature: ___________________________________________________________

Date: ____________

Please print and sign this form. The request will not be processed without a signature. Hand deliver or submit by mail to: Office of the Registrar, 105 Main Building, Notre Dame, IN 46556 or fax to: (574) 631-5872. If you have additional questions regarding this form, please contact the Office of the Registrar at (574) 631-7043 or find further information at the transcript web site.