Transcript Request Form

Fill out this form to request a paper transcript from Martin Luther College.

Name*
First Last
Maiden/Previous Name
Phone
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Last 4 of SSN*
Month/Day of Birth*
Send Transcript To: (#1)
To whom should we send your transcript?
Institution/Company/Individual Name*
Institution/Company/Individual Name Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Number of copies requested*
- 1 copy
- 2 copy
- 3 copies
Special Instructions
Do you need to send a transcript to a second address?
- Yes
- No
Send Transcript To: (#2, if needed)
Institution/Company/Individual Name (#2)
Institution/Company/Individual Name Address (#2)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Send Transcript To: (#1)