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Academic Assessment, Office of
Career Success, Bastian Family Center for
College Engagement, Office of Advancement
Community Service, Mark & Jeannette Kleine Center for
Disability Support Services, Office of
Global Studies, Eleanor Stellyes Center for
Government & Community Relations, Office of
Information Technology Services
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International Student Services, Office of
Knox Advisory Committee on Socially Responsible Investing
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Please print this transcript request form below or download a PDF, complete, and mail, email or fax it to us.
Please mail request with the $5 fee per transcript to:
Office of the Registrar
Campus Box 145
Knox College
2 East South Street
Galesburg, IL 61401
You can also fax your request with a billing address to:
(309) 341-7601
Or, you can email this document as an attached PDF (including your signature) to registrar@knox.edu.
PERSONAL INFORMATION AND BILLING ADDRESS
Student ID Number (if known): _____________ Phone Number: (_____ )______- _______
Student Name (Please Print): __________________________________________________________
Street: ____________________________________________________
City: ____________________________________ State:___________
Zip: ____________
Country:_________
Last Year Attended: _________________________
PURPOSE OF TRANSCRIPT
Please check:
______ Grad School (field: _________________________ )
______ Medical School, Dental School
______ Fellowship, Scholarship
______ Transfer
______ Off-Campus Study (Program: __________________ )
______ Military Service
______ Peace Corps
______ Teaching Certificate
______ Job Application
______ Other
SEND TRANSCRIPTS TO...
Please send my transcript(s) to the following addresses:
1) _____________________________________________________
Number of Copies: ______
_______________________________________________________
_______________________________________________________
_______________________________________________________
2) _____________________________________________________
Number of Copies: ______
_______________________________________________________
_______________________________________________________
_______________________________________________________
3) ____________________________________________________
Number of Copies: ______
_______________________________________________________
_______________________________________________________
_______________________________________________________
AUTHORIZATION
I authorize Knox College to release my Knox College Transcript to the parties named on this form.
SIGNATURE: _______________________________________________________
Date: ___________________