Official Transcript Request

Official Transcript Request *Print this page and send to all previous schools attended.

To: Office of the Registrar, Student Records 

Name of High School, College, or Seminary

__________________________________

Address: 

City: __________________State: ______________

Zip: _____________

 

Student Name:________________________________

Maiden or Previous Name:_____________________________

Social Security Number: ____________________

Branch or Campus attended: _________________________________

Date first attended: ___________

Date last attended:_____________

Degree (s) Received: ____________________________

 

Student Signature ___________________________________   

Date___________________________

 

Mailing Address ______________________________________________________________________ (Street or P.O. Box Number)

City_______________________ State_________________ Zip________________

*Print this page and send to all previous schools attended.

 

Please forward one official copy of my transcript to:

Southern Bible College & Seminary

Office of Admissions

P.O. Box 764

Lenoir City, Tennessee 37771-0764