Transcript, Diploma, Degree Request Form

Request an Official or Unofficial Transcript, or A Copy of your Diploma

Note: Transcript requests CANNOT be processed for former students with a balance owed to the College

Current Full Name *

Former Name (if you attended under a different name)

Phone Number *

E-Mail *

Date of Birth *

Program Attended *

When did you attend Orion Institute? *

Current Address *

City *

State *

Zip Code *

Which are you requesting: Transcript, Diploma, or Degree? (Choose One) *

How would you like your requested document to be sent? *

If you need an Official Transcript sent to additional addresses, please list the additional addresses below. Addresses listed should be formatted similarly to the following example.

First Name Last Name

1234 Street Name

City, State, Zip Code

Please be sure to include full addresses including who the document is to be addressed to, street address, city, state, and zip code for each additional address. Incorrectly formatted addresses or addresses missing information will not have a transcript sent.

Selecting this checkbox and entering your name below constitutes an electronic signature and confirmation that you wish to have your selected components of your academic records released to the designated addresses and individuals listed on this form. *

Please type your full name to serve as an electronic signature. *

I herby certify and declare that this academic record belongs to me. Everything stated above is true and accurate to the best of my ability. *

Request an Official or Unofficial Transcript, or A Copy of your Diploma

If you need an Official Transcript sent to additional addresses, please list the additional addresses below. Addresses listed should be formatted similarly to the following example.

First Name Last Name

1234 Street Name

City, State, Zip Code

Pertinent Information

Equal Opportunity for People with Disabilities