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
Trang 1GRADUATE STUDENT PLEASE PRINT CLEARLY (black/blue ink only)
OFFICE OF THE REGISTRAR
9980 Carroll Canyon Road, San Diego, CA 92131
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 _
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
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