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TEXAS SOUTHERN UNIVERSITY Enrollment Services Office of the Registrar 3100 Cleburne Street Houston Texas 77004 713 313-7071 Transcript Request Form Name Last First Middle Mailing address Street City State Zip Date of Birth SS Month Date Year Telephone E-mail Other names used at TSU School Business Education Law etc. Degree s earned if applicable PLEASE FILL IN THE BLANK AND CHECK THE APPROPRIATE BOX ES Please send official transcript s of credit earned by me during my attendance at Texas Southern University. Hold for degree. Indicate semester and year of graduation application Hold for grades. Your transcript will be sent when all of the courses in which you are now enrolled have been graded* Hold for grade change. Your transcript will be sent when Registration and Academic Records receives a change of grade for the course in the semester you indicated below. Course Number Section Semester/Year FORM OF PAYMENT All admission requirements and financial obligations must be met before transcripts are released Credit Card Visa MasterCard Discover American Express Account Number Expiration Date Name of cardholder Cardholder s signature Check Payment made in the office of the Bursar Contacted the Bursar s Office CHECK ONE STUDENT WILL PICK UP TRANSCRIPT PLEASE MAIL TRANSCRIPT TO ADDRESS BELOW Student Name Address Signature Date Day All transcript requests require student signature. Federal Law prohibits the release of your transcript without written signature. A computer-generated signature cannot be accepted*. Hold for degree. Indicate semester and year of graduation application Hold for grades. Your transcript will be sent when all of the courses in which you are now enrolled have been graded* Hold for grade change. Your transcript will be sent when Registration and Academic Records receives a change of grade for the course in the semester you indicated below. Your transcript will be sent when Registration and Academic Records receives a change of grade for the course in the semester you indicated below. Course Number Section Semester/Year FORM OF PAYMENT All admission requirements and financial obligations must be met before transcripts are released Credit Card Visa MasterCard Discover American Express Account Number Expiration Date Name of cardholder Cardholder s signature Check Payment made in the office of the Bursar Contacted the Bursar s Office CHECK ONE STUDENT WILL PICK UP TRANSCRIPT PLEASE MAIL TRANSCRIPT TO ADDRESS BELOW Student Name Address Signature Date Day All transcript requests require student signature. Course Number Section Semester/Year FORM OF PAYMENT All admission requirements and financial obligations must be met before transcripts are released Credit Card Visa MasterCard Discover American Express Account Number Expiration Date Name of cardholder Cardholder s signature Check Payment made in the office of the Bursar Contacted the Bursar s Office CHECK ONE STUDENT WILL PICK UP TRANSCRIPT PLEASE MAIL TRANSCRIPT TO ADDRESS BELOW Student Name Address Signature Date Day All transcript requests require student signature. Federal Law prohibits the release of your transcript without written signature. A computer-generated signature cannot be accepted*. .

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