TRANSCRIPT REQUEST FORM

TODAY’S DATE:  ________________________

NOTE:  No transcript will be issued unless at least one graded Park University course appears on the transcript.

                No outstanding balance may show on the student’s account.

                No transcript (Official or Unofficial) can be ordered by phone.

                Transcripts must be ordered through the Mail or on-line at https://www.park.edu/registrar/transcripts

LAST DATE OF                                         DID YOU GRADUATE:   NO: _______________

MAIL REQUEST TO:                                          ATTENDANCE: ____________                                                         YES: _______________

PARK UNIVERSITY                                                                                                                                                                                                                                      Date Graduated

TRANSCRIPT CLERK, CMB 27                                                                   

8700 RIVER PARK DRIVE                                                                           STUDENT I.D. NO: _________________________

PARKVILLE, MO 64152-3795                                                                                                                                          

                                                                                                                           SOC. SEC. NO:  ___________________________

NAME:  _______________________________________________________________________________

                       (LAST)                                                      (FIRST)                               (MI)                                     (MAIDEN)

CURRENT ADDRESS:  ____________________________________________________________________

                                           (STREET)                                                                                               (APT. NO.)

 ____________________________________________________________________________________PHONE:____________________________________

       (CITY)                                                                   (STATE)                                             (ZIP)                                                          

MAY WE UPDATE YOUR ADDRESS IN OUR DATA BASE? ______YES     ______NO

DID YOU ATTEND:                                                                CHECK ONE:

____ HOME CAMPUS                                                           _____ SEND NOW.  DO NOT HOLD FOR GRADES                            

____ METROPARK                                                 _____ HOLD FOR CURRENT SEMESTER GRADES

                        ____ DOWNTOWN                                                       _____ HOLD FOR DEGREE STATEMENT

                        ____ INDEPENDENCE                                   

                        ____ PARKVILLE

_____ MILITARY CAMPUS CENTER                                      _____ TEACHER PLACEMENT FILE                                      

               _______________LOCATION                                                 _____  OFFICIAL  ($20.00)

                                                                                                                                _____  UNOFFICIAL  ($10.00)                                            

____ GRADUATE SCHOOL                       

UNDERGRADUATE TRANSCRIPT                               GRADUATE  TRANSCRIPT

#____  UNOFFICIAL  (NO CHARGE)                            #____  UNOFFICIAL  (NO CHARGE)

#____  OFFICIAL  ($10.00 PER COPY)                         #____  OFFICIAL  ($10.00 PER COPY)

*Personal checks must have Driver’s License number, Issuing State and Expiration Date noted.*

STUDENT SIGNATURE: ______________________________________________ (REQUIRED TO AUTHORIZE RELEASE) 

SEND TRANSCRIPTS TO:     (WRITE LEGIBLY AND GIVE COMPLETE ADDRESS)

                                                __________________________________________________________________

                                                                        __________________________________________________________________

                                                                        __________________________________________________________________

                                                                        __________________________________________________________________

(Official transcripts are mailed directly to students will be stamped "Official Transcript Issued to Student in Sealed Envelope")

(Academic transcripts are confidential information and are included under the Privacy Act (Buckley Act))