Official Transcript Request Form
Unofficial Transcript Request Form

Social Security Number - -
Date of Birth / /

Enrollment Dates From To

Student's Full Name and Address
Last First Phone Number
Middle Maiden
Street Apt. City
State Zip Code

Send my transcript to:

Number of Copies:

Cardholder's Name

Card #

Card Exp. Date
Month Year

Zip Code

Amount $

Special Instructions - Hold Transcript Until:
Degree Completion Statement (available once requirements have been met)
Degree Conferred to Print on Transcript (only available after graduation date)
Grades posted for Term Year

In order for your transcript to be issued all financial obligations to Averett University must be satisfied.


The Family Educational Rights and Privacy Act of 1974 requires written authorization from the student before transcripts can be released.

Signature of Student