NMT Records Request Form

NMT Records Request Form

Please complete this form to request access to your records. Ensure all information is accurate to expedite the process. A minimum 5 page fee of $5.00 is due with submission of this form.
Requestor Information

Section 1
Requestor's Full Name

First NameMiddle NameLast Name
Requestors Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Requestor's Email Address
example@example.com
Requestor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Records Requsted

Section 2
Type of Records Requested
Date Range for Records
Detailed Description of Records Needed
Reason for your request
Is there any documents that you would like to share with us? Upload them here.

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Verification of Identity

Section 3
To ensure compliance with FERPA, please provide the following form of identification and either your student ID number or last 4 of your SSN:
Government-issued Photo ID upload

If a photo ID is not provided or is non-legible, your request will be deemed invalid.
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I am providing my:
Student ID number (if applicable, begins with 900)
Last 4 or SSN
Return of record

Section 4
Preferred Method of Receiving Records
Mailing Address (if paper copy is selected)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Payment

section 5
- A minimum non-refundable fee of $5.00 for 5 pages is required with this request.
- Requests that produce more than 5 single- pages of documentation will be charged at an additional $1.00 per page.
- Once payment has been completed, you must upload your receipt below.
Payment Link (click the link below):

M-Mountain Mall Registrar Record Request payment
Record request payment receipt upload

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Authorization

section 6
Important Notes
- Records will only be released to the verified student of record listed on this form and in accordance with FERPA regulations.
- Please allow up to 45 days from the time of your request for processing your request.
- Returned records incur a cost of $1.00 per page within a minimum fee of $5.00.
- Contact registrar@nmt.edu for any questions.
This form is designed to ensure that you comply with FERPA while obtaining educational records.
Signature (by signing below, you authorize the release of your records as requested above:
Date

MonthDayYear
Date
I confirm that the information provided in this request is accurate and complete. I understand that providing false information may delay or invalidate this request.
For Office Use Only
- Date Received: _______________________________
- Processed by: ________________________________
- Response Date: _______________________________
- Method of Response:
  - ☐ Mail
  - ☐ In-person pickup
Should be Empty:

NMT Records Request Form

Requestor Information

Records Requsted

Verification of Identity

Return of record

Payment

Authorization