School Transcript Request

International Development Institute

P.O. BOX 20260 – New York, NY 10001 - Tel: (212) 970-2424 (212) 970-2424

Permission to Obtain Academic Records from Previous School
Please complete all required fields. This authorizes release of your official transcript.

The student indicated below has applied for admission to this school. In order to process the application,
we must have an official copy of the student’s academic record from your institution.

Request Details

Date *

Date is required.

Student’s Date of Birth *

Date of birth is required.

Social Security # *

Enter SSN as XXX-XX-XXXX.

Provide the number used while attending, if different.

Student Name

Last Name (as on our school records) *

Last name required.

First Name *

First name required.

Middle Name

Other Legal Name Used

Parent Information (for identification)

Father’s Last, First

Mother’s Maiden Name: Last, First

Address at Time of Attendance at IDI

Home Address *

Street address required.

Apt.

City/Town *

City required.

State *

Use 2-letter code (e.g., NY).

Zip Code *

Enter a valid ZIP.

School From Which Information is Requested Name and Address of School *

School name and address required.

Dates of Attendance – From *

Start date required.

Dates of Attendance – To *

End date required.

Return transcripts to:
Credential Verification Office
International Development Institute
P.O. BOX 20260 – New York, NY 10001

Authorization

I authorize the release of my school transcript to International Development Institute.

You haven't signed yet. Please complete your signature above.

Date *

Signature date required.