Note: If you are an established member, you can email Academ with your request and send payment by regular mail.

REQUEST FOR FILE

PRINT NAME_______________________________________ NAME CHANGE? YES__ NO__
ADDRESS_______________________________________ ADDRESS CHANGE? YES__ NO__
CITY/STATE_____________________________________________ZIP____________
SOCIAL SECURITY NUMBER (ID)_________________________PHONE ( __)_____-_________
E-mail: _____________________________

In making this request I state, to the best of my knowledge, that my file held by ACADEM is complete, that it represents all educational records and course work taken to date.

SIGNATURE___________________________________DATE____________

Enclose $15.00 for each transcript file, $25.00 for transcript and letters of recommendation file. (For letters only $10.00) -- (for files issued outside of the US add $2.00 per file) Send this request to ACADEM, P.O. Box 6431, Oceanside, CA, 92052-6431

All transcript files are official unless sent to you for personal use. Please indicate if the file must be sent to you directly for state teacher certification or employment, in which case it will be marked ÒUnofficial if seal is broken.Ó Forward the file, unopened, with your other documents to assure officiality of transcripts. To assure confidentiality, letters of recommendation are always sent directly to prospective employers, never to clients.

Please list any additional requests on the back.
For additional requests print this form again and send with others.

email us at ACADEM@aol.com