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WESTERN CONNECTICUT STATE UNIVERSITY TRANSCRIPT REQUEST Office of the Registrar 181 White Street Danbury CT 06810 Fax 203 837 9049 Phone 203 837 9200 Student Data STUDENT NAME Last First Middle Initial Official Transcripts Unofficial Transcripts MAIDEN NAME or name while attending Mail Transcript 3. Students may receive an official copy stamped ISSUED TO STUDENT. PRINT CLEARLY FOR DIRECT MAILING IN WINDOW ENVELOPES I hereby authorize WESTERN CONNECTICUT STATE UNIVERSITY to release official copies of my academic record to the person or institution named at the left with the SEND TO Name and address if to yourself write SELF understanding that the named recipient will not release the record to a third party without my written consent. Date Signature Student Date Transcript Sent of copies to be sent to this address Falsifying a student s signature is a violation of FERPA regulations. After current semester grades for 1. Immediately Student ID or Social Security Number fall 2. After degree is posted spring BIRTH DATE PHONE NUMBER Currently Enrolled at WCSU Last Semester or Year Attended Yes No WCSU Degree Part Time Full Time Summer Undergrad Grad if awarded Only summer YOUR NAME AND ADDRESS Please print clearly TRANSCRIPT INFORMATION OFFICIAL TRANSCRIPTS affixed with the university seal are sent directly to a third party. Students may receive an official copy stamped ISSUED TO STUDENT. PRINT CLEARLY FOR DIRECT MAILING IN WINDOW ENVELOPES I hereby authorize WESTERN CONNECTICUT STATE UNIVERSITY to release official copies of my academic record to the person or institution named at the left with the SEND TO Name and address if to yourself write SELF understanding that the named recipient will not release the record to a third party without my written consent. After current semester grades for 1. Immediately Student ID or Social Security Number fall 2. After degree is posted spring BIRTH DATE PHONE NUMBER Currently Enrolled at WCSU Last Semester or Year Attended Yes No WCSU Degree Part Time Full Time Summer Undergrad Grad if awarded Only summer YOUR NAME AND ADDRESS Please print clearly TRANSCRIPT INFORMATION OFFICIAL TRANSCRIPTS affixed with the university seal are sent directly to a third party. Students may receive an official copy stamped ISSUED TO STUDENT. PRINT CLEARLY FOR DIRECT MAILING IN WINDOW ENVELOPES I hereby authorize WESTERN CONNECTICUT STATE UNIVERSITY to release official copies of my academic record to the person or institution named at the left with the SEND TO Name and address if to yourself write SELF understanding that the named recipient will not release the record to a third party without my written consent. Date Signature Student Date Transcript Sent of copies to be sent to this address Falsifying a student s signature is a violation of FERPA regulations. .

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