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High School & College Transcript Request Form: Student Information

This document is a high school and college transcript request form for David Jeffrey Cole. It provides his personal information and requests that Liberty University obtain official transcripts from Broadmoor High School, where he graduated in 1999, and ITI Technical College, where he attended from 2008-2010 and earned an Associate degree. Cole authorizes the release of these education records to Liberty University for the purpose of his application for admission.

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Jeff Cole
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77 views

High School & College Transcript Request Form: Student Information

This document is a high school and college transcript request form for David Jeffrey Cole. It provides his personal information and requests that Liberty University obtain official transcripts from Broadmoor High School, where he graduated in 1999, and ITI Technical College, where he attended from 2008-2010 and earned an Associate degree. Cole authorizes the release of these education records to Liberty University for the purpose of his application for admission.

Uploaded by

Jeff Cole
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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High School & College Transcript Request Form

Please fax signed form to 888-301-3577 or email to [email protected]

Student Information
Name: David Jeffrey Cole Liberty ID: DOB: 08 / 08 / 1980

Social Security Number: 436414254 Campus: Online

High School & College Information


Liberty University, Inc. will submit requests for official transcripts on your behalf to the institutions identified herein. If Liberty University, Inc. is unable
to obtain an official transcript from an institution, you will be responsible for obtaining the official transcript and submitting it to Liberty University, Inc. in
order to complete the application for admission.

High School/GED Request

Name under which you attended: David Cole High School: Broadmoor High School

Phone: 2259608834 City: Baton Rouge State: LA ZIP: 70815-4521

Graduation Date: 05 / 1999 Diploma Type: Standard

College Transcript Request

Name under which you attended: David Cole College: ITI Technical College

Phone: 2259608834 City: Baton Rouge State: LA ZIP: 70817-5927

Dates Attended: 08 / 2008 - 04 / 2010 Degree Completed? Yes Degree Level: Associate Outstanding Balance? No

The information requested is protected by the Family Educational Rights and Privacy Act of 1973 (FERPA). I authorize Liberty University, Inc., on my
behalf, to submit requests for transcripts, diploma, or degree documents to any of the identified institutions and to execute (electronically or otherwise)
any transcript request forms on my behalf necessary for the release of such education records. I authorize the identified institutions to release to Liberty
University, Inc. the transcripts, diploma, or degree documents requested on my behalf by Liberty University, Inc. for purposes of my application for ad-
mission. Liberty University, Inc. may execute on my behalf any transcript request forms or other required documents necessary to complete this request.

Student's Signature: Date: 08 / 04 / 2020

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For use by responding educational institution/agency only


The information in this document is protected by the rules and regulations of the Family Educational Rights and Privacy Act (FERPA). Please allow only-
authorized personnel of your institution to view and process this request.

If you, as the institution/agency, cannot provide the requested transcript, please send notification to our address listed below and indicate the following:

Name of Institution: Mail to:

Reason: Liberty University:


Student does not appear to have attended our institution ATTN: Admissions Verification
Student record is not available for release 1971 University Blvd MSC Box 710686
Lynchburg, VA 24515

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