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TRANSCRIPT & DIPLOMA REQUEST / EDUCATION VERIFICATION Fee: Official transcripts are $7.50 per copy at time of request, diplomas are $15.00 per copy at time of request, no fee for education verification. Please complete all information: Official transcripts requested Unofficial transcripts requested Education verification only Duplicate diploma request Student Name Campus att ended Other Name(s) used Current address City State Zip Phone number Phone number other Email Address Date of birth Student ID or SSN Program Dates Att ended Enrollment status: Current Student Graduate Withdrawn Action Requested (select one): Fax to: Attention Fax number ( ) Email to (for Education Verifications Only) Mail to Address City State Zip Other Instructions Student Signature (REQUIRED) Date Mail the completed form and payment (check, money order, or credit card) to the campus location attended • Attention: Registrar Please contact campus for fax instructions. • Documents cannot be released without the student’s signature. • Processing can take up to 30 days. • Failure to complete exit counseling may result in placement of a hold on student’s records, which would prevent fulfillment of transcript requests and release of graduates’ diploma. • Diplomas and transcripts are not released to students with outstanding balances on their student accounts. • Carrington College can only release transcripts from Carrington College (formerly Western Career College, Apollo College or American Institute of Health T echnology). Registrar use only Amount paid $ Receipt # Request completed by Date completed Date sent to Home Office Home Office received on Home Office response date ©2017 Carrington College. All rights reserved carrington.edu

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Page 1: TRANSCRIPT & DIPLOMA REQUEST / EDUCATION · PDF fileOfficial transcripts requested Unofficial transcripts requested Education verification only Duplicate diploma request ... which

TRANSCRIPT & DIPLOMA REQUEST / EDUCATION VERIFICATION Fee: Official transcripts are $7.50 per copy at time of request, diplomas are $15.00 per copy at time of request, no fee for education verification.

Please complete all information:

Official transcripts requested Unofficial transcripts requested Education verification only Duplicate diploma request

Student Name Campus attended

Other Name(s) used

Current address

City State Zip

Phone number Phone number other

Email Address

Date of birth Student ID or SSN

Program Dates Attended

Enrollment status: Current Student Graduate Withdrawn

Action Requested (select one):

Fax to: Attention Fax number ( )

Email to (for Education Verifications Only)

Mail to

Address

City State Zip

Other Instructions

Student Signature (REQUIRED) Date

Mail the completed form and payment (check, money order, or credit card) to the campus location attended • Attention: Registrar Please contact campus for fax instructions.

• Documents cannot be released without the student’s signature.

• Processing can take up to 30 days.

• Failure to complete exit counseling may result in placement of a hold on student’s records, which would prevent fulfillment of transcript

requests and release of graduates’ diploma.

• Diplomas and transcripts are not released to students with outstanding balances on their student accounts.

• Carrington College can only release transcripts from Carrington College (formerly Western Career College, Apollo College or

American Institute of Health Technology).

Registrar use only

Amount paid $ Receipt #

Request completed by Date completed

Date sent to Home Office Home Office received on

Home Office response date

©2017 Carrington College. All rights reserved carrington.edu

Page 2: TRANSCRIPT & DIPLOMA REQUEST / EDUCATION · PDF fileOfficial transcripts requested Unofficial transcripts requested Education verification only Duplicate diploma request ... which

Student Name Student D# (if known)

CREDIT CARD PAYMENT AUTHORIZATION

Card Information:

Discover (CA Locations Only) American Express (Outside CA Locations Only) Master Card Visa

Amount authorized to charge credit card

Debit/Credit card number

Expiration Date Three digit CSV number on back of card

Cardholder Authorized Signature

Cardholder Name (please PRINT)

Address City State Zip

Daytime Phone Number Email Address

Albuquerque Campus

1001 Menaul Blvd. NE Albuquerque, NM 87107

505-254-7777

Boise Campus

1122 N. Liberty St.

Boise, ID 83704

208-377-8080

Citrus Heights Campus

7301 Greenback Lane

Suite A

Citrus Heights, CA 95621

916-722-8200

Las Vegas Campus

5740 S. Eastern Ave. Suite 140

Las Vegas, NV 89119

702-688-4300

Mesa Campus

1001 W. Southern Ave.

Suite 130

Mesa, AZ 85210 480-212-1600

Mesquite Campus

3733 W. Emporium Circle

Mesquite, TX 75150

972-682-2800

Pomona Campus

901 Corporate Center Drive

Suite 300

Pomona, CA 91768

909-868-5800

Online

8909 Folsom Boulevard

Sacramento, CA 95826

916-361-1660

Portland Campus

2004 Lloyd Center, 3rd Floor

Portland, OR 97232

503-761-6100

Phoenix North Campus

8503 N. 27th Ave.

Phoenix, AZ 85051

602-393-5900

Reno Campus

5580 Kietzke Ln.

Reno, NV 89511

775-335-2900

Phoenix East Campus

2149 W. Dunlap Ave. Suite 100

Phoenix, AZ 85021

602-433-1333

Sacramento Campus

8909 Folsom Boulevard

Sacramento, CA 95826

916-361-1660

Pleasant Hill Campus

380 Civic Drive

Suite 300

Pleasant Hill, CA 94523

925-609-6650

San Jose Campus

5883 Rue Ferrari, Suite 125

San Jose, CA 95138

408-960-0162

San Leandro Campus

15555 E. 14th Street

Suite 500

San Leandro, CA 94578

510-276-3888

Spokane Campus

10102 E. Knox Ave.

Suite 200

Spokane, WA 99206

509-532-8888

Stockton Campus

1313 W. Robinhood Drive

Suite B

Stockton, CA 95207

209-956-1240

Tucson Campus

201 N. Bonita Avenue

Suite 101

Tucson AZ, 85745

520-888-5885


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