Records Retrieval Request

Please complete this form to request your records. This form is for use by university office personnel only.

Requester's Name: (Required)

Office: (Required)

E-Mail Address: (Required)

Phone:

Accession Number: (Required)

Box Number: (Required)

Folder Title: (Required)

Location on Transmittal Form: (Required)

Preferred Return (Required)

choose one

Will pick records up
Records may be sent via campus mail

Notes: