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Transcript Request: Request Cannot Be Processed If A Student Has Holds. No Charge Except For Overnight Delivery

This document is a transcript request form from Mesa State College's Office of the Registrar. It requests the student's name, ID number, dates of attendance, and delivery options. The student can choose to have the transcript processed immediately, or held if there are outstanding grades or degrees. They can pick up the transcript themselves with ID, or have it sent to other institutions. There is no charge except for overnight delivery, for which a fee of $13.75 per delivery address applies. The form collects payment and signature information for overnight requests.

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45 views1 page

Transcript Request: Request Cannot Be Processed If A Student Has Holds. No Charge Except For Overnight Delivery

This document is a transcript request form from Mesa State College's Office of the Registrar. It requests the student's name, ID number, dates of attendance, and delivery options. The student can choose to have the transcript processed immediately, or held if there are outstanding grades or degrees. They can pick up the transcript themselves with ID, or have it sent to other institutions. There is no charge except for overnight delivery, for which a fee of $13.75 per delivery address applies. The form collects payment and signature information for overnight requests.

Uploaded by

api-23049350
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Office of the Registrar

1100 North Avenue


TRANSCRIPT REQUEST Grand Junction, CO 81501-3122
(970) 248-1555 Fax (970) 248-1131
1-800-982-MESA

Request cannot be processed if a student has holds. No Charge except for overnight delivery.
Please print clearly.

Name: Student ID #
Last First MI

All Other Name(s) Previously Used


Address: Phone #:
Birthdate:
Last Date Attended:
PLEASE CHECK ONE OF THESE PROCESSING OPTIONS:
‰ Process Immediately
‰ Hold for Change of Grade (Course Name: Course Ref #: )
‰ Hold for Current Semester Grades
‰ Hold for Degree Statement
PLEASE CHECK DESIRED DELIVERY OPTION:
‰ Pick-up at the Registrar’s Office by Self (must have a photo ID).
‰ Pick up at the Registrar’s Office by (must have a photo ID).
‰ Send my official Mesa State College Transcript(s) to:
( ) ( )
Quantity Name Quantity Name

P.O. Box or Street Number P.O. Box or Street Number

City State Zip City State Zip

Total Number of Student’s Signature Date


Transcripts Ordered

‰ Deliver my transcript(s) overnight for a fee of $13.75 per each delivery address.
Please use the following payment method:
‰ Check or money order enclosed in the amount of $
‰ Bill my credit card for a total of $ (Sorry, American Express is not accepted.)

Card Number Expiration Date

Name of Cardholder as printed on card Signature of Cardholder

----FOR OFFICE USE ONLY----

Received by: Holds Checked: Processed by: Date: ______

R:\Registrar\Forms-Office\TRANSCRP\tran-req2.doc, rev 03/05

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