Energy I Liberty

High School & College Transcript Request Form

Please fax signed form to 888-***-**** or email to *********@*******.*** Student Information

Name: Thomas Lester Cole Liberty ID: DOB: 01 / 02 / 1954 Social Security Number: ***-**-**** Campus: Online High School & College Information

Liberty University, Inc. will submit requests for official transcripts on your behalf to the institutions identified herein. If Liberty University, Inc. is unable to obtain an official transcript from an institution, you will be responsible for obtaining the official transcript and submitting it to Liberty University, Inc. in order to complete the application for admission.

High School/GED Request

Name under which you attended: Thomas Cole High School: Valle Lindo High School Phone: +117******** City: El Monte State: CA ZIP: 91732-2569 Graduation Date: / Diploma Type: Applied Studies

College Transcript Request

Name under which you attended: Thomas Cole College: Bismarck State college Phone: 1-701-***-**** City: Bismarck State: ND ZIP: 58630 Dates Attended: 09 / 2000 - 11 / 2001 Degree Completed? Yes Degree Level: Associate Outstanding Balance? No The information requested is protected by the Family Educational Rights and Privacy Act of 1973 (FERPA). I authorize Liberty University, Inc., on my behalf, to submit requests for transcripts, diploma, or degree documents to any of the identified institutions and to execute (electronically or otherwise) any transcript request forms on my behalf necessary for the release of such education records. I authorize the identified institutions to release to Liberty University, Inc. the transcripts, diploma, or degree documents requested on my behalf by Liberty University, Inc. for purposes of my application for ad- mission. Liberty University, Inc. may execute on my behalf any transcript request forms or other required documents necessary to complete this request. Student's Signature: Date: 05 / 22 / 2022

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - For use by responding educational institution/agency only The information in this document is protected by the rules and regulations of the Family Educational Rights and Privacy Act (FERPA). Please allow only- authorized personnel of your institution to view and process this request. If you, as the institution/agency, cannot provide the requested transcript, please send notification to our address listed below and indicate the following: Name of Institution: Mail to:

Reason: Liberty University:

Student does not appear to have attended our institution ATTN: Admissions Verification Student record is not available for release 1971 University Blvd MSC Box 710686 Lynchburg, VA 24515

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