High School Office

Colorado

A X V Technical

University.

HIGH S C H O O L / G . E . D . R E Q U E S T F O R T R A N S C R I P T S

P lease c omplete a separate form for each institution attended.

INFORIVIATION O F INSTITUTION ATTENDED

ATTN: Registrar/Records

Name of High School:

Address of School:

City, State, Zip/Postal Code:

student: Please ensure that you fill out the address information above accurately and completely so that we can

receive your transcripts in a timely manner

STUDENT INFORMATION

Name:

Name when attending, if different from above:

Date of Birth:

Social Security #:

Current address of student:

State : Zip/Postal Code:

City:

(from MMA^Y to MM/YY)

Dates Attended:

P lease s end one (1) official transcript for the above student to:

Colorado Technical University

4435 N Chestnut Street, Suite E

Colorado Springs, CO 80907

Toll Free Number: 866-***-**** Option 3

Fax: 866-***-****

Student Signature Date:

For Office Use Only: Payment of S is enclosed

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