>
       
  Name of Student    
  Phone Number  
EmailID  
ConfirmEmailID  
       
Name While Attending School (if different from above)
       
  Name of Student    
   
     
  School Attended
  SSN
   
Address where transcript is to be sent:
     
  Mailling Address 1
  Mailling Address 2
  City
  State
  Zip
  Number of Transcripts
  Amount
     
Payment Module:
     
 
Payment Method:
Please mail this form along with a  Money Order (made payable to Department of Postsecondary Education) to:
Department of Postsecondary Education,
Attn: Closed Private School Transcript,
P.O. Box 302130,
Montgomery, AL 36130.
  Mailling Address 1
  Mailling Address 2
  City
  State
  Zip
     
       
  Card Type
  Name of Card  
  Card Number  
  Expiration date [mm/yy]  
  CVV2/CD  
  Card Zip Code