North Central Transcript Request Form
TRANSCRIPT REQUEST MAIL IN FORM $10 Fee per Official Transcript
Name
FILL OUT THE FOLLOWING Previous Name
Email or Mail Request to: registrar@ncu.edu
Northcentral University Attn: Registrar's Office 8667 E. Hartford Drive Suite 110 Scottsdale Arizona 85255 FAX: 928-541-7817
Email Address
Student ID#
or Last 4 digits of SS#
Date of Birth
Dates of Attendance
Year Graduated, if applicable
Address
City, State, Zip
Phone
Number of copies needed:________
Send: Now
When Grades are Posted:
* Mail transcript to:
Requesting: Official After degree awarded:
Unofficial
Name
Institution
Address **Email transcript to:
City
State
Zip
* Print receiver's name or "Self" if you would like the transcript(s) sent to you. Official transcripts must be in a sealed envelope and are not to be opened by student. If requesting more than one address, please fill out page 2.
** Please verify that the institution will accept an electronic version of your official transcript before requesting an electronic version be sent.
PAYMENT INFORMATION
Check Enclosed:
Amount of check ($10 x # of official transcripts ordered): $
Pay by Credit Card: Visa
MasterCard
AMEX
Discover
Credit Card #
Exp. Date
Signature
Date
With my signature, I authorize Northcentral University to release copies of my academic
records to the person or institution indicated above with the understanding that the named
recipient will not release the record to a third party without my written consent.
ew_6-6-11
ADDITIONAL TRANSCRIPTS REQUESTED
Send: Now
When Grades are Posted:
After degree awarded:
Mail transcript to:
Requesting: Official
Unofficial
Name
Institution
Address
City
State
Zip
Email transcript to:_________________________________________________
Send: Now
When Grades are Posted:
Mail transcript to:
After degree awarded: Requesting: Official
Unofficial
Name
Institution
Address
City
State
Zip
Email transcript to:_________________________________________________
Send: Now
When Grades are Posted:
Mail transcript to:
After degree awarded: Requesting: Official
Unofficial
Name
Institution
Address
City
State
Zip
Email transcript to:_________________________________________________
Send: Now
When Grades are Posted:
Mail transcript to:
After degree awarded: Requesting: Official
Unofficial
Name
Institution
Address
City
State
Zip
Email transcript to:_________________________________________________
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