Academic Transcript Request Form - Heriot

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ACADEMIC TRANSCRIPT REQUEST
An Academic Transcript is an official letter providing a student/graduate or third party* with a
student's/graduate's final grades and any award details. Estimated turnaround time: 10 – 14
working days. Please see disclaimer at
http://www.hw.ac.uk/students/studies/record/confirming-your-student-status.htm
*Third party requests for data on students require written consent from the student/graduate concerned. There is no charge for requests going directly to a
third party. Please indicate below.
Personal Details
Full Name
ID Number (if known)
Date of Birth
Email Address
Contact Number
Address (only required if transcript is being sent directly to student/graduate)
Address of third party (only required if transcript is being sent directly to
third party organisation/institute/employer)
Please do not pass my details to the Alumni Department at Heriot-Watt University
 (tick)
(This information is used to keep in touch with you via Magazines, E-Newsletters and Event Invites after graduation)
Programme of Study, Request Details and Authorisation
Award Title/Programme Title (e.g. Information Technology)
No. of original copies required? (£10 each)
No. of photocopies required? Original
must be purchased first. (£1 each)
Qualification (e.g. Bachelor of Science)
Transcript going directly to a third party.
DHL courier service (£25)? (Please tick)
Graduation/Leaving Date
Total to pay
AUTHORISING SIGNATURE
Signature:
£
Date:
Method of Payment
Credit Card Type (will incur 1.75% charge)
MasterCard

Visa
Debit Card Type

Switch/Maestro 
Switch Issue No. __
Visa Debit/Delta

*We are unable to take payment remotely from a Visa Electron Card
Card Details
Valid From Date:
Expiry Date:
Security Code:
(Last 3 digits on signature strip)
Long Card Number:
Name of Cardholder:
Signature:
Date:
Office Use Only:
Cost Centre:
Date Processed:
Academic Registry
SLS
EPS
SML
EGIS
SBC
MACS
EBS
CALD
Date Sent to AR/School/Institute:
Please return this form to:
Student Service Centre, Hugh Nisbet Building, Heriot-Watt University, Riccarton, Edinburgh, EH14 4AS. Fax 0131 451 8253. Email
StudentCentre@hw.ac.uk. Student Service Centre, Heriot-Watt University Malaysia, MYStudentCentre@hw.ac.uk
Free
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