Transcript Request Form 

REQUESTS BY FAX, E-MAIL OR CREDIT CARD PAYMENTS WILL NOT BE ACCEPTED! 

There is a $7.00 fee for each transcript request (official or student copy). The fee is NOT required 
for requests sent to CUNY institutions. Checks or money orders should be payable to Lehman College. 

 
**If you have any Negative Service Indicator(s) on your record, your request cannot be processed** 

 

PERSONAL INFORMATION: (PLEASE PRINT) 

Last Name: _______________________________________________


First Name: ______________________________________________


M.I:  _________________________


Name while attending Lehman College (If not the same as above): ___________________________________



Circle One:   Social Security Number ___________________      EMPLID (CUNYfirst) __________________



Address: _______________________________________________


City: _______________________


State: ______________________


Zip Code: ___________________

 
Contact Number: ____________________________


Email Address: ______________________________



 
Would you like to update your information with Alumni Relations? (Circle one): YES          NO


Are you an Alumni/Alumnus? (Circle one): YES          NO



DATE OF ATTENDANCE:


Are you currently attending Lehman College? (Circle one): YES          NO


If not, state the semester you last attended: _________________________


REQUEST FOR (Circle one):

Official Transcript- Mailed directly to institution/business 

 OR

Official Transcript- Mailed directly to the student in sealed 
envelope 


Include name of institution/business here: ________________________________




ADDRESS WHERE TRANSCRIPT IS TO BE SENT: 


Institution/Business Name: _________________________________________________


Attention: _________________________________________________________________


Address: ___________________________________________________________________


City: ______________________________________________________________________


State: _____________________________________________________________________


Zip Code: __________________________________________________________________





The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C.S.123g) protects the confidentiality 
of student’s educational records. Student records can only be released with the student’s 
written authorization. 

 

This request will not be processed without the student’s signature. 



Student Signature ____________________________________________     Date ________________________ 


 

FOR OFFICE USE ONLY: 

Received Date: ______/______/_____ 

Processed By: ____________________ Date: ______/______/_____