Transcript Request Form



Complete request form, print, and sign.
Mail or fax request to the Office of the Registrar.

Office of the Registrar
Western Illinois University
1 University Circle
Macomb, IL 61455-1390

Phone: (309) 298-1891
Fax: (309) 298-2787
WIU ID (or Soc. Sec. No.):       Date of Birth (mm/dd/yyyy):

Name:      Previous Name(s):
Street:
City:    St: Zip:          Phone#:
Send Transcript
Pick Up Transcript		 | Process Immediately                  Hold For Grade Change
| Hold For Grades                                  Course:
| Hold For Degree                                  Semester:
|       Degree:
Number of Copies:            Send to: 






Number of Copies:            Send to: 




 Number of Copies:            Send to: 






Number of Copies:            Send to: 

PLEASE NOTE THE FOLLOWING REGULATIONS:
1) No transcript is issued to or for a student who is indebted to the University or has an administrative encumbrance until such hold has been cleared.
2) Ordinarily transcripts will be issued within one week. Allow at least three weeks at the end of the term.
3) Transcripts are released only at the written request of the student.


Signature:_____________________________________________ Date:_____________________

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