Request for International Transcript

Instructions: To request transcripts, fill out a request form and mail it to the address at right. Be sure to include a check or money order. For each transcript requested, the cost is $4.70.

PLEASE PRINT OR TYPE

Attn: Transcripts
Office of the Registrar
Washington State University
PO Box 641035
Pullman, WA 99164-1035

Last Name:
___________________

First Name:
___________________

Middle Name:
___________________

Former Name:
___________________

______ Currently Enrolled

______ Last Term Enrolled

______ Year and ______ Term

Please mark your choice below.

_____ Mail Transcript(s) to:
_____ Hold For Pick Up

__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
(Enter additional addresses on the back of this form.)

All copies requested will be stamped Official with the Registrar's signature and placed in a sealed
envelope and mailed out US Mail or ready for pickup after 3 pm no later than the 4th business day.

I hereby authorize the Registrar's Office to release copies of the below listed transcripts in my file:

Name of Foreign Institution (Non-U.S. Only): _________________________________________

Number of Copies: _________

Name of Foregin Institution (Non-U.S. Only): _________________________________________	Number of Copies: _________
Name of Foreign Institution (Non-U.S. Only): _________________________________________	Number of Copies: _________

Telephone Number ______________
Email Address _________________
Student ID Number _____________
SSN ______-____-________
Birth date ____/____/________

It is unlawful for WSU to deny to any individual any right, benefit, or privilege provided by law because the individual refuses to disclose his or her social security number except in very limited circumstances. WSU requests the voluntary disclosure of your social security number on this form. If provided, WSU will use your social security number for only the following purposes: Verification of records.

I HEREBY AUTHORIZE THE RELEASE
OF MY TRANSCRIPT.

Signature _______________________Date__________
(Please print your name and address below.)

________________________________________________
________________________________________________
________________________________________________
________________________________________________

THIS FORM MUST BE SIGNED!