Transcript Request Form

 

First transcript ever ordered is free. Thereafter, the charge is $5.00/copy.  Transcripts on-demand (same day service) are $20.00 each.  On-demand/overnight shipping transcripts are $40 each.  On-demand and on-demand/overnight requests must be received by 2:00 PM for same day service.  Cash, checks, or credit cards are accepted.  Make checks payable to Moravian College. If paying by credit card, please fill out the credit card information section below.  To order official transcripts, please complete  the form below and fax or mail (along with payment if necessary) to:

 

            Registrar’s Office

            Moravian College

            1200 Main St.

            Bethlehem, PA  18018

            FAX:  610-625-7871

 

Name________________________________________ Maiden Name ____________________________

Street Address ________________________________City __________________State_____Zip_______

Date of Request _________________________ Daytime Phone _________________________________

Currently Enrolled _______ yes _______ no   Date Last Attended _______________________________

Social Security or Student ID number________________________       Date of Birth______________

 

Signature ____________________________________________________________________________

                  (Your signature is required in order for us to release this information.)

 

Please send  ______ copy(ies) to:           Please send ______ on-demand copy(ies) to:         

 

Please send ______ on-demand/overnight shipping copy (ies) to:

 

 

Official transcripts are issued in sealed envelopes; if seal is broken, the transcript is considered unofficial.

 

I hereby authorize MORAVIAN COLLEGE to charge my credit card (below) for transcripts.

 

Amount Authorized ________________          Date ___________________________________

 

Signature ____________________________________________________________________________

 

NAME ON CREDIT CARD:

HOME ADDRESS OF PERSON ON CREDIT CARD:

DAYTIME PHONE (incl. area code):

CARD TYPE  (MasterCard, Visa, or Discover)

CARD NUMBER (16 digits):                                                                                                           EXP. DATE (mo/yr):