Form

Kemper Military School Transcript Request Form
In order to request a copy or copies of your transcript, a processing fee is required. We accept credit cards (Discover, Master Card, or Visa), money orders, or checks made payable to The State Historical Society of Missouri. If you are paying by credit card, please pay via the online form at:

http://shsofmo.org/store/misc-payment.html or contact us by telephone to process your payment. Please select John Konzal as the Staff Member Name and mention Kemper Military School Transcript Request in the comments field.

The processing fee entitles the student to up to 10 copies of their transcript in one year. Please note that after 1 year, additional requests will require another processing fee.

You may also fax the completed form to our fax number at 573-884-4950, attention: John Konzal

Mail requests to:
The State Historical Society of Missouri
Attn: John Konzal
1020 Lowry Street
Columbia, MO 65201

FEES
- State Historical Society of Missouri Members $5.00
  *Please include your membership number
- Missouri Nonmembers $10.00
- Out-of-state Nonmembers $15.00
Questions should be directed to John Konzal at 573-884-6912 or konzalj@umsystem.edu

If the records for a former student cannot be located, a staff member will notify the student and the school/employer with a standard letter explaining the disposition of the Academy’s records. Any fee will be returned to the student.
Click to edit*
/ Month / Day Year
Full Name*
Last Name First Name Middle Name
E-mail*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*
- Area Code Phone Number
Birth Date*
Month Day Year
Last 4 Digits of SS#*
Dates attended*
(yyyy-yyyy)
Total No. of transcripts requested*
If you wish copies of your transcript to be sent to specific institutions, please include the full address and name of person or department to send transcript to below.
Full Name
First Name Last Name
Department

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Please provide any additional instructions here:
Additional Institutions to send transcripts to:
Institution 1:
Full Name
First Name Last Name
Department

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Number of transcripts to be sent to this institution
Please provide any additional instructions here:
Institution 2:
Full Name
First Name Last Name
Department

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Number of transcripts to be sent to this institution
Please provide any additional instructions here:
Instructions

1. Print completed form to mail

2. Submit completed form online

3. Pay fee
Handwritten Signature ___________________________________
Date _________________
Should be Empty:

Kemper Military School Transcript Request Form

Handwritten Signature ___________________________________

Date _________________