Graduate School, USDA Transcript Request Form |
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Office of the Registrar
Graduate School, USDA
Suite 180
600 Maryland Avenue,S.W.
Washington, DC 20024
Fax #: (202) 479-2500
Office #: (202) 314-3340 |
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TRANSCRIPT REQUEST FORM |
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This form must be signed and payment attached before a transcript can be issued. Allow a minimum |
of ten days for processing. |
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Print out this page and complete all eight items and return to the address above. Please print legibly. |
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1. Name _________________________________________________________________________________ |
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Last |
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First |
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Middle |
Name While Attending |
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Social Security Number______________________________Date of Birth___________________ |
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Daytime Telephone Number ( )_____________E-mail Address __________________________ |
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2. Address ____________________________________________________________________________ |
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Number & Street |
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City______________________________________________State/Zip Code__________________ |
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3. Check if you are currently enrolled ( ) |
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OR indicate approximate dates of attendance |
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First Year Enrolled_____________________Last Year Enrolled___________________________ |
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4. Number of official (School Seal) transcripts to be mailed to each address below. |
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(A transcript request will not be processed for a student who is indebted to the School.) |
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Send transcript to the address below: (Official transcripts are $5.00 each) |
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1) # of Copies _____ |
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2) # of Copies____ |
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______________________________________ _________________________________________ |
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______________________________________ _________________________________________ |
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______________________________________ _________________________________________ |
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______________________________________ _________________________________________ |
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______________________________________ _________________________________________ |
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Deadline: __________ |
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Deadline: __________ |
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5. Number of unofficial (without School Seal) transcipts to be mailed to the |
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address in Item #2. # of Unofficial Copies ________. First unofficial copy is free. |
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6. Check One |
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(_____) |
Pick up or mail in 48 hours - RUSH Transcript - $10.00 each |
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(_____) |
Send now, do NOT hold for current grades. |
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(_____) |
Send after current grades received. |
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(_____) |
Fax unofficial Copy. Fax # is_______________________________________________ |
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7. Method of Payment: Cash ( ) |
Check ( ) |
Money Order ( ) |
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American Express ( ) VISA ( ) MasterCard ( ) Diner's Club ( ) |
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Card Number:_________________________________Expiration Date:_____________________ |
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# of Official Copies: _________ |
times $ 5.00 = ________________ |
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# of Official Rush Copies:_____ |
times $10.00 = _______________ |
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# of Unofficial Copies: _______ |
times $ 5.00 = ________________ |
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Total Due |
= ________________ |
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8. _______________________________________________Date of Request________________________ |
SIGNATURE (MANDATORY for release of trascript) |
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The Family Rights and Privacy Act as amended in 1995 prohibits release of this information |
without the student's written consent. |
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