APPLICATION FOR THE ISSUE OF A DUPLICATE TRANSCRIPT
PLEASE ALLOW 5 – 10 WORKING DAYS FOR PROCESSING
(Please note that during certain periods of peak activity throughout the year eg: Exams in May/August, Graduation in July/December,
the processing of your application may be subject to delay)
1
A Transcript lists the modules undertaken, credit value and grades achieved during each academic session, (where this
information is available from the University’s records). The overall result obtained will also be indicated.
2
The transcript which the University issues to students is a unique and valuable document which should be carefully
preserved by its recipient.
3
A duplicate will only be issued at the discretion of the University. The University reserves the right not to issue a duplicate
or to specify reasons for its decision.
4
The applicant must provide payment by credit/debit card or cheque appropriate to the scale of charges overleaf. Cheques
should be made payable to the “University of Central Lancashire”. Please include the cheque card guarantee number
on the reverse of the cheque.
Please complete in BLOCK CAPITALS
First Name .............................................................................. Surname ........................................................................................
Student Enrolment Number/Certificate Number .............................................................................................................................
Date of Birth .....................................................................................................................................................................................
Title of Course .................................................................................................................................................................................
Year of Award/Attendance (eg 2003)...............................................................................................................................................
Current Address...............................................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
Post Code ........................................ Daytime  ..........................................................................................................................
Contact e-mail address ....................................................................................................................................................................
No. of transcripts requested ............................................ Amount enclosed £ ....................................................... GBP
Signature ................................................................. Date ........................................................................................
Return this completed form to: Examinations and Awards, University of Central Lancashire, Preston, Lancashire, PR1 2HE.
Fax: 01772 892946
For office use only
Receipt Number:
Date processed:
Delete as applicable: Cash/Cheque/Visa
Date of posting:
University of Central Lancashire
Scale of Charges for Transcripts
Confirmed at June 2000 or later
Copy
1
2
3
4
5
6
7
8
9
10
Charge GBP
£
Free of Charge
15
20
25
30
35
40
45
50
55
Additional Charges
Certified copies
GBP 5.00 per copy
Mailing to other institutions
GBP 5.00 per institution
MAIL ORDER-CREDIT/DEBIT CARD DETAILS
Full Name
...................................................................................................................
(customer)
Full Name
...................................................................................................................
(of cardholder if different than above)
Address
(ONLY if a receipt is required)
....................................................................................................
......................................................................................................................................
......................................................................................................................................
Post Code
.........................................
Today's Date
....................................
(Mandatory)
Amount
............................................
In payment of
...................................
Student Ref. No.
..............................
Card Type(visa etc)
...........................
Card No:
Start Date ........................................
(if applicable)
Security Code ....................................
(last 3 digits from signature strip on reverse of card)
(4 digits from front of card for American Express )
Expiry Date
......................................
Switch Issue No
................................
(if applicable - card no. usually starts with 6...)
Email address
.............................................................................................................
(This will automatically forward receipt when using Worldpay)
Telephone No.
............................................................................................................
......................................................................................................................................
Cashiers Office use only
Receipt No
.......................................
Date of Receipt .................................