X-Script Req. Form

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SACRED HEART MAJOR SEMINARY TRANSCRIPT REQUEST FORM Office of the Registrar * 2701 Chicago Blvd. * Detroit, MI 48206-1799 Tel (313) 883-8512 * Fax (313) 883-8682 Registrar@shms.edu * Official transcripts will not be released until all financial obligations to the seminary have been satisfied. STUDENT INFORMATION ALL blocks in student section must be completed - PLEASE PRINT LEGIBLY - Thank You Last 4-digits of S.S. # LAST NAME FIRST NAME MIDDLE NAME COMPLETE MAILING ADDRESS - STREET, CITY, STATE & ZIP Do you want us to update your SHMS/SJPS record to show this as your permanent address? List any other names under which you may have attended SHMS/SJPS: Approximate date(s) you attended SHMS/SJPS: Level of Study: BIRTHDATE . Undergraduate Graduate School: SHMS Degree Awarded: YES NO St. John Provincial Seminary Both DATE DAYTIME PHONE # STUDENT SIGNATURE TRANSCRIPT HANDLING INSTRUCTIONS FEE $5.00 fee ea $5.00 fee ea $5.00 fee ea DESCRIPTION Please mail this transcript to the recipient indicated below. QTY Please HOLD request until GRADES are posted for: FA WI SP SU Please HOLD request until DEGREES are posted for: FA WI SP SU I want an UNOFFICIAL copy of my transcript sent to the Office for Clergy Life & Ministry No charge No charge for Permanent Diaconate Candidates after each term for the - Academic Year. I want an UNOFFICIAL copy of my transcript. A check is enclosed in the amount of WINTER SUMMER $0.00 FALL TOTAL: 0 MAILING INFORMATION List the complete mailing address(es) of where you would like your transcript(s) sent to. PLEASE PRINT LEGIBLY Name: Office: Institution: Address: City/State/Zip: Name: Office: Institution: Address: City/State/Zip: FOR INTERNAL USE ONLY Accepted By Holds PDO Chg. PDO Billed Billed By Input By Proofed & Mailed $0.00

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