TRANSCRIPT REQUEST FOR INSTITUTIONS OTHER THAN UNO

(Transcripts are required from each college or university attended)

 

To:

                                                       Name of Institution

     

                                                        Address of Insitution

     

                             City                                             State                     Zip-Code

 

 

From:                  Student's Last Name                       First                        Middle            

Date of Birth:    / /

                                Month                 Day                Year

Any other names on record:

 

Social Security Number:

(or Former Student Number)   

Dates of Attendance: /        to    /

                                                 Month           Year                                   Month          Year    

 

Please send two (2) official transcript directly to:

               Office of Graduate Studies

               University of Nebraska at Omaha

               6001 Dodge Street

               Omaha, NE 68182-0209   

 

I have enclosed the requested transcript fee of : $

Comments:

                    

                    

                                

                          

                               Signature of Student                                                Date