Graduate Student Release of Official Transcript Form

OFFICE OF THE REGISTRAR 9980 Carroll Canyon Road, San Diego, CA 92131 GRADUATE STUDENT PLEASE PRINT CLEARLY (black/blue ink only) LAST NAME FIRST _ SUFFIX _ MIDDLE SSN DOB (MM/DD/YYYY) EMAIL _ PHONE/CELL _ STREET ADDRESS _ APT/SUITE CITY _ STATE _ ZIP CODE _ FORMER NAMES: _ ATTENDANCE DATES: I have applied for admission to National University and my signature hereby authorizes you to furnish National University with an official transcript of my academic record while I was a student at your institution A photocopy of this authorization will be as valid as the original, even though the photocopy does not contain an original of my signature This authorization is valid for one year from date below SIGNATURE _ DATE Please sign the form with a wet signature Forms without wet signature will be voided TRANSCRIPT REQUEST FORM STUDENTS: COMPLETE ONE (1) FORM PER INSTITUTION (PRINT CLEARLY) INSTITUTION NAME (no abbreviations) _ INSTITUTION ADDRESS CITY STATE _ ZIP CODE _ ATTENTION RECORDS/REGISTRAR’S OFFICE 1) If you encounter any difficulties in processing this request, please contact National University Records & Enrollment Department at 858-642-8270 or transcripts@nu.edu 2) Please send one (1) official, sealed transcript to: NATIONAL UNIVERISTY RECORDS & ENROLLMENT 9980 CARROLL CANYON ROAD SAN DIEGO, CA 92131 or 3) Please securely transmit one (1) official transcript electronically if utilizing a certified electronic transcript exchange system (eTranscript California, NSC, Credential Solutions) REV 5/2017 GRFT