Student's Name (Please Print)

Last_________________________________________ First______________________________ M.I.____

(Prior Name)____________________________________________________________________________

Social Security No. _____________________________________ Last Year Attended Nicolet ______________

Mailing Address ____________________________________________________________________________

City and State _____________________________________________________ Zip Code _______________

Telephone ____________________________

SEND TRANSCRIPT TO: __________________________________________________________________

Address ________________________________________________________________________________

City _____________________________________________ State _____________ Zip Code _____________

Prepare Transcripts(check one box only) __Now __Hold for Final Grades __Hold Until Degree Info is Entered

Number of Transcripts _________________ $2.00 per Transcript. $5.00 for Same Day Service.

Student Signature ____________________________________________ Date ____________________

Only regular Credit Classes taken at Nicolet will show on Transcript. No Transcript will be issued if there are any outstanding debts at Nicolet.

In order to get a transcript we need your written permission and the fee. The fee is $2.00 per copy for next day service or $5.00 per copy for same day processing. We need to know where to send your transcript with the address, your signed signature and social security number. Please send to Records, NATC, PO Box 518, Rhinelander, WI 54501, or you can fax this same information using VISA, MASTER CARD or DISCOVER with the expiration date to 715-365-4411.

If you have questions, please call our office at 715-365-4422 or 1-800-544-3039 ext.4422.
Thank you.