Office of the Registrar 1200 E. California Blvd.
MC 125-87
Pasadena, CA 91125
(626) 395-6354 fax: (626) 395-6121
TRANSCRIPT REQUEST
This form can be filled out with Adobe Acrobat and then printed for signature.
STUDENT NAME: ____________________________________________________________________
First Middle Last
Other name(s) under which you may have attended: _________________________________________
SIGNATURE (required; no e-signature):___________________________ Date (required): ___________
Degree(s) BS, MS, Eng, Ph.D: _______________________________ Degree awarded: ______________
Major(s): ___________________________________________ Minor: __________________________
Date of Birth: ____________________ Dates of Attendance: _________________________________
Cell Phone: ______________________ Email Address: _____________________________________
Payment Information
A check, money order or credit card may be used to pay. Please provide information below for EITHER a check or
money order OR a credit card. Please make the check or money order payable to: Caltech Registrar’s Office.
Official transcripts are $10 each. For additional shipping information and fees please see
Registrar’s website.
Check or money order enclosed in the amount of $_______.
Other methods of payments are Visa or Master Card.
Name on Card: _________________________ Expiration date: ____/____ Amount to charge: ________
Credit Card number: ___________________________ Security #: _______ Billing Zip Code: _________
Mail transcript(s) to: # of Transcripts: _________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
FedEx will not deliver to a PO Box; please provide a physical address.
If you have more addresses, please write or type them on another page and include it with your request.
Rev. 09/23/22