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Electronic Transcript Order Form

Submit Your Deposit
The windows of Old Main.

Please print the electronic transcript request form below or download a PDF, complete, and mail, email, or fax it to us. Be sure that your signature is included.

Please mail request with the $5 fee per transcript to:
Office of the Registrar
Campus Box 145
Knox College
2 East South Street
Galesburg, IL 61401

You can also fax your request with a billing address to:
(309) 341-7601

Or, you can email this document as an attached PDF (including your signature) to:

Please read the following information about electronic transcripts before you complete this form.

The e-Scrip-Safe network allows Knox to securely transmit an official transcripts in pdf format to a website, from which the recipient can claim it. The recipient is notified by email that an official transcript is ready to be claimed and given instructions on how to do it securely. The student is also informed by e-mail when the transcript has been sent by Knox and given instructions on how to track it at the eScrip-Safe website.

Many institutions belong to the eScrip-Safe receiving network. Before completing your transcript request, check the updated list of these institutions and use the institution name as shown. These institutions are set up to receive transcripts easily. You may send electronic transcripts to a non-network person or institution as well. We must have the name of an individual who is to receive it and that person's e-mail address for tracking purposes. Do not simply use an office or business name for the recipient. And you should always notify your intended recipient that they will be receiving email messages regarding the electronic delivery of a transcript. To insure delivery, ask the recipient to add the domain name to their safe sender list.


Student ID Number (if known): _____________ Phone Number: (_____ )______- _______

Student Name (Please Print): __________________________________________________________

Street: ____________________________________________________

City: ____________________________________ State:___________

Zip: ____________


e-mail address:______________________________

Last Year Attended: _________________________


Please check:

______ Grad School (field: _________________________ )

______ Medical School, Dental School

______ Fellowship, Scholarship

______ Transfer

______ Off-Campus Study (Program: __________________ )

______ Military Service

______ Peace Corps

______ Teaching Certificate

______ Job Application

______ Other


Please send my transcript(s) to the following addresses:

1) (name)_____________________________________________________

Number of Copies: ______

(e-mail address of recipient)____________________________________

(physical address of recipient)________________________________________



2) (name)_____________________________________________________

Number of Copies: ______

(e-mail address of recipient_____________________________________

(physical address of recipient)________________________________________



3) (name)____________________________________________________

Number of Copies: ______

(e-mail address of recipient)____________________________________

(physical address of recipient)________________________________________




I authorize Knox College to release my Knox College Transcript to the parties named on this form.

SIGNATURE: _______________________________________________________

Date: ___________________

Knox College

Printed on Wednesday, February 26, 2020