Transcript Request Form

Institution *

Holy Family College (formerly known as Silver Lake College)

Mount Senario College

First Name *

Middle Name/Middle Initial

Last Name *

Other Name(s) (Birth/Married)

Date of Birth *

Month

Day

Year

Social Security Number (last 4 digits) * 000-00-

If you do not have a SSN, please enter "0000".

Dates of attendance

Please note approximate dates of attendance or graduation (e.g. "Fall 2004-Spring 2008" or "Graduated in Spring 1998").

Current Address - Number and Street

Current Address - City

Current Address - State

Current Address - ZIP

Daytime Telephone *

Email Address *

Number of OFFICIAL Transcripts Requested ($10 Each)

Official transcripts bear the seal of the college; ***CANNOT be mailed to student.*** Provide mailing addresses below.

Mailing Address(es) for OFFICIAL Transcripts

Note the purpose of the transcript request (job application, college application, other) and provide the mailing address (name, street address, city, state, and ZIP).

Number of UNOFFICIAL Transcripts Requested ($10 Each)

Unofficial transcripts are marked "Issued to Student"; do not bear the seal of the college; can be mailed to student).

Mailing Address(es) for UNOFFICIAL Transcripts

Note purpose of transcript request (job application, college application, other) and provide the address (name, street address, city, state, and ZIP) OR note "mail to me."

Payment Options

Check or money order made payable to WAICU

PayPal

Checks or money orders may be made payable to "WAICU" and mailed to: Wisconsin Association of Independent Colleges and Universities (WAICU), Attn: Transcripts, P.O. Box 272, Madison, WI 53701-0272 Please note the name of the student or graduate in the memo field.

Name on PayPal Account (If Applicable)

Date Paid on PayPal (If Applicable)

Month

Day

Year

E-Signature (Type Name) *

Authorization *

I authorize WAICU to release my transcript.

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Transcript Request Form