TRANSCRIPT REQUEST FORM
UNDERGRADUATE REGISTRAR'S OFFICE
209 WHITMORE ADMINISTRATION BUILDING
UNIVERSITY OF MASSACHUSETTS
181 PRESIDENTS DRIVE
AMHERST, MA 01003-9313
voice 413.545.0555
fax 413.545.2920
STUDENT INFORMATION
Current Name __________________________________________________________________________________
Last
First
Middle
Former Name (if applicable) _____________________________________________________
Student ID# or SS# ___________________________
Date of Birth ______________________________
Email Address ______________________________________ Telephone Number _________________________
Dates of Attendance__________________________________
Current Mailing Address
_________________________________________________
_________________________________________________
_________________________________________________
TRANSCRIPT INFORMATION (please allow 3-5 business days for processing)
Official Transcript
Unofficial Transcript
Number of Transcripts ______
*You can have your unofficial transcripts faxed, fill out below:
Fax # _______________________
Transcript(s) will be picked up
or
Mail Transcript(s) to:
***actual mailing time can take up to two weeks to reach the destination***
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
OR, hold request and
mail transcript(s) after
Fall grades recorded
Spring grades recorded
Winter grades recorded
Summer grades recorded
Degree awarded on transcript
________________________________________________
Student Signature Required
_________________________
Date of Request
Charges:
There is no fee for students who have entered the University as of September 1990 or later.
If you entered the University prior to September of 1990, there is a service fee of $6.00 for each transcript.
rev 04/11/2011