TRANSCRIPT REQUEST
S TAT E U N I V E R S I T Y O F N E W Y O R K
Office of Records & Registration, SUNY New Paltz, 500 Hawk Drive, New Paltz, NY 12561-2439
(845) 257-3100 email: recreg@newpaltz.edu fax: (845) 257-3103
To request a transcript, mail this form with $5 per copy, cash, check, or money order payable to SUNY/New Paltz. Or, you may
email or fax the form with credit card information (Visa, MasterCard or American Express). Upon receipt of the request, generally
allow 3-5 business days for processing. If a deadline is indicated, every effort will be made to honor it.
DISCLAIMER: No request can be honored for a person whose account is not cleared.
Please type or PRINT CLEARLY:
N
__________________________________________________________________
Last Name
First Student ID (if known)
MI
__________________________________________________________________ ___________________________________
__________________________________________________________________
(________)__________________________
Telephone Number
Local Address: Street
Apt. No. City
State
Zip Code
Previous name(s)___________________________________________________ Attended New Paltz E-mail
Date of Birth _______________________ Dates: _____________ to ______________
SEND TRANSCRIPT TO:
Number of copies _________________
__________________________________________________________________
Check one only:
Undergraduate only
Graduate only
Undergraduate and Graduate
Person or Office
__________________________________________________________________ College or Company
__________________________________________________________________ CURRENT STUDENTS ONLY
Street
Select one if applicable:
__________________________________________________________________
Mail after my grades are recorded.
City
State
Zip Code
check one:
Fall
Winter
Spring
Summer
Mail before deadline of ___________ .
__________________________________________________________________ Signature (REQUIRED)Date
Mail after graduation is posted.
FOR CREDIT CARD PAYMENT
Visa
MasterCard
American Express
Credit Card #_______________________________________ Name on Card______________________________________
Exp. Date____________________ Signature__________________________________________
Sec. Code________ (REQUIRED)
11/13 • 38-019