TRANSCRIPT REQUEST FORM 3KRQH_)D[_ZZZSDWWHQHGX (QUROOPHQW6HUYLFHV5HJLVWUDU¶V2IILFH:\FOLIIH+DOO&RROLGJH$YH2DNODQG&$ Student Information 6WXGHQW1DPH /DVW )LUVW 6RFLDO6HFXULW\1XPEHU 0, 'DWHRI%LUWK Maiden Name/ Other Legal Names $GGUHVV (PDLO 6WUHHW$GGUHVV $SW32%R[ 3KRQH &LW\ 6WDWH =LS :HUH\RXHQUROOHGDW3DWWHQ8QLYHUVLW\EHIRUH" <HV 1R :HUH\RXHQUROOHGLQRQOLQHFRXUVHVDW3DWWHQ8QLYHUVLW\" <HV 1R Delivery Information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ll transcript requests must be received in writing. You may come to the Registrar’s Office in person and fill out a transcript request form. If a personal visit is not possible, please send a completed Transcript Request form of a letter with the information noted below. Official transcripts are sent directly to a college, employer, student or other agency and bear the university seal. Unofficial transcripts may be mailed, faxed or emailed directly to the student or other agencies listed above. No transcript (Official or Unofficial) will be released if the student has an outstanding balance due to the university. In accordance with Federal Law (The Family Educational Rights and Privacy Act, FERPA), student transcripts are issued only at the written request of the student. A transcript will not be released with out the student’s signature appearing on the request. Transcript requests are not accepted by telephone. How to Request a Transcript Transcript requests are processed within 7 business days of receipt. In order for the Registrar to process a transcript the student must submit a written request. Please include the following information: • • • • • • • Full Name (while attending Patten University) Social Security Number Date of Birth Phone number Current address Transcript delivery information Signature Please Note: • Transcript requests cannot be honored from those students whose financial records at the university are not in good standing. All account balances (including bad debt) must be paid in full prior to releasing a transcript (Official or Unofficial). • A second party may not request a transcript on the student’s behalf. The law protects the confidentiality of a student’s education record. The written request ensures that Patten University meets the requirements of the Family Educational Rights and Privacy Act. • A second party may not pick up a transcript on a student’s behalf with out written consent of the student. Written consent can be submitted directly to the Registrar’s Office. You can submit your request by: • Fax: 510-534-8969 ( Do not mail original request if faxed) • Email: [email protected] • Mail: Registrar's Office - Transcripts 2433 Coolidge Ave. Oakland, CA 94601
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