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Consent To Release Information From Education Records: ST Cloud State University

This document is a transcript order consent form authorizing St. Cloud State University to release an official transcript of the student's education record to Lahore University of Management Sciences in Lahore, Pakistan. The student, Hafiz Raza, signed the form, authorizing the order number 16011697. The form provides instructions that the signed consent form must be faxed, mailed or emailed to the National Student Clearinghouse in order to complete the transcript order.

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Basim Raza
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24 views

Consent To Release Information From Education Records: ST Cloud State University

This document is a transcript order consent form authorizing St. Cloud State University to release an official transcript of the student's education record to Lahore University of Management Sciences in Lahore, Pakistan. The student, Hafiz Raza, signed the form, authorizing the order number 16011697. The form provides instructions that the signed consent form must be faxed, mailed or emailed to the National Student Clearinghouse in order to complete the transcript order.

Uploaded by

Basim Raza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Transcript Order Number:

16011697

Consent to Release Information from Education Records


Only the student him/herself may sign this form
The undersigned individual authorizes

St Cloud State University


__

to release the official transcript of his/her education record to the individuals and/or organizations (recipients) on this order and
agrees to the charges on his/her credit or debit card resulting from this order (which will appear on his/her credit or debit card
statement as College Transcript).
__

Recipients:
Name

Mailing Address (if applicable)

LAHORE UNIVERSITY OF
MANAGEMENT SCIENCES
(LUMS)

OPPOSITE SECTOR U, DHA., LAHORE, OPPOSITE


SECTOR U, DHA., LAHORE
LAHORE, PUNJAB, 54792, PK

Student Name: HAFIZ RAZA

Authorized for Order Number: 16011697

Student Signature

Date

In order to complete your transcript order, you must fax, mail or email a signed and dated copy of this consent form to the Clearinghouse.
DO NOT RETURN THIS FORM TO THE SCHOOL. When we receive your consent form, National Student Clearinghouse will send you a
notification (via email or text, depending on what you selected as your preference) once the consent form has been processed. We will
not confirm receipt of your consent form over the telephone.

Instructions
If we do not receive your signed and dated consent form within 30 calendar days from the date you submitted
your request, your order will be canceled and you will not be charged.
Fax:

703-742-4238 (remember to dial the 1 before the area code)

Mail:

National Student Clearinghouse, 2300 Dulles Station Boulevard, Suite 300, Herndon, VA

Email:

[email protected]

The information contained in this transmission may contain privileged and confidential information. It is intended only for the use of the person(s) named above and the
National Student Clearinghouse. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this
communication is strictly prohibited. If you are not the intended recipient, please destroy all copies of the original message.

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