OFFICIAL TRANSCRIPT REQUEST FORM
UNDERGRADUATE REGISTRAR'S OFFICE
213 WHITMORE ADMINISTRATION BUILDING
UNIVERSITY OF MASSACHUSETTS
181 PRESIDENTS DRIVE
AMHERST, MA 01003-9313
voice 413.545.0555
fax 413.545.2920
STUDENT INFORMATION
Current Name __________________________________________________________________________________
Last
First
Middle
Former Name (if applicable) _____________________________________________________
Student ID# or SS# ___________________________
Date of Birth ______________________________
Email Address ______________________________________ Telephone Number _________________________
Dates of Attendance__________________________________
Current Mailing Address
_________________________________________________
_________________________________________________
________________________________________________________
TRANSCRIPT INFORMATION (please allow 3-5 business days for processing)
Number of Transcripts ______
Transcript(s) will be picked up
or
Mail Transcript(s) to:
***actual mailing time can take up to two weeks to reach the destination***
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
OR, hold request and
mail transcript(s) after
Fall grades recorded
Spring grades recorded
Winter grades recorded
Summer grades recorded
Degree awarded on transcript
________________________________________________
Student Signature Required
_________________________
Date of Request
Charges:
If you entered the University September of 1990 or thereafter, you have paid a Registrars Service Fee that entitles you to
free transcripts for life.
If you entered the University prior to September of 1990, there is a service fee of $6.00 for each transcript.
rev 03/13/09