Western Illinois University

FUTURE STUDENTS:
Course Offerings | Academic Departments | Colleges

Transcript Request Form

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

Student Information
WIU ID (or Soc. Sec. No.): - - Email: Name: Previous Name(s): Street: Date of Birth (mm/dd/yyyy): City: State: Zip: Phone#:
Processing Options
Send Transcript Pick Up Transcript	Process Immediately Hold For Grade Change Hold For Grades Course: Hold For Degree Semester: Degree: To request your own official transcripts be issued to you in a sealed envelope.

Mailing Address Information
Number of Copies: Send to: Number of Copies: Send to:	Number of Copies: Send to: Number of Copies: Send to:

Authorization
PLEASE NOTE THE FOLLOWING REGULATIONS: 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. Ordinarily transcripts will be issued within one week. Allow at least three weeks at the end of the term. Transcripts are released only at the written request of the student. Signature:_______________________________________________________ Date:__________________________

Authorization

PLEASE NOTE THE FOLLOWING REGULATIONS:

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.
Ordinarily transcripts will be issued within one week. Allow at least three weeks at the end of the term.
Transcripts are released only at the written request of the student.

Signature:_______________________________________________________ Date:__________________________