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