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Student Service Record Request Form
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Please fill out the following form.  Once you hit "Submit" the information will be sent to the VSLC to be processed.  Please be advised that it may take 3-5 days for your request to be completed.

(* indicates a required field.)

*1). Date of Request (mm-dd-yyyy):
*2). First Name:
*3). Last Name:
*4). Banner Number:
*5). Email Address:
*6). Phone Number:
*7). Check one of the following: Please mail my Student Service Record to the address noted below. Please notify me via email when my record is ready to be picked up in the VSLC office during normal business hours.
8). The address where I need my record to be sent to is:
9). Additional requests/comments: