Transcript Request Form

You will need to print this web page on your local printer and then mail or fax it to us. See also complete instructions for transcript requests.

Cost is $10.00 per transcript.

Please print legibly.

Date: ____________________

S.S.N. / Student ID #: ________________________

Date of Birth: ____________________

Name and Address

 

______________________

__________________

____________

Last

First

Middle

 

_____________________________________________________

Street

 

__________________________________

______

____________

City

State

Zip Code

 

______________________

_______-_______-_______

Former Last Name

Phone #

_________________________________________

Email Address

Other Information

Are you currently enrolled?   ___ Yes   ___ No

Did you attend UK prior to Fall 1988?   ___ Yes   ___ No

Did you attend Northern Community College or Fort Knox?   ___ Yes   ___ No

Dates of attendance:   __________________ to __________________

This office does not process transcripts for the Colleges of Medicine or Dentistry.

Mail To Address

 

 

 

Student's Signature

In accordance with Federal Law and KRS 164.283, records cannot be released without the written consent of the student.

_________________________________________________

R009 (Rev. 07/09)

 

University of Kentucky
University Registrar
10 Funkhouser Building
Lexington, KY 40506-0054
(859) 257-3671
Fax: (859) 257-7160

Check All that Apply:

___ Mail
___ Pick-up
___ Place each transcript in an official envelope with Registrar's stamp

___ Hold for end-of-semester grades
___ Fall
___ Spring
___ 4-week
___ 8-week

___ Hold for posting of degree
Degree _______________________

___ Hold for grade change or repeat option
Course _______________ Grade ____

___OVERNIGHT SERVICE:

The University does not pay for overnight service. The cost for overnight service will be charged to your credit card and will be billed directly from the overnight service provider. We must have a complete street address (no post office boxes), city, state, zip code and telephone number for overnight service. If you wish for Saturday delivery, check the box below. There is an additional charge for Saturday delivery. Overnight service is not available for work completed prior to Fall 1988.

___         Yes, I want to pay for Saturday delivery.

Total # of Transcripts ______________

Payment by Credit Card

Credit Card #: ________________________
3-Digit Verification Code (on the back of credit card) __________
Exp. Date: _________
___ Visa
___ MasterCard

Note

Transcripts will not be released if the student has an outstanding financial obligation to the University of Kentucky. Transcripts sent to or picked-up by student will state "Official Transcript Issued to Student."

Office Use Only

Amt. Paid: __________  Amt. Due: _________
Received by: ________ 017  Checked: ______