ISSUING INSTITUTION

Please forward an Official Transcript to:

Teach for a Change

c/o Admissions at University of Great Falls

1301 20th Street South

Great Falls, MT 59405

Name: ______________________________________________________
SSN: _ _ _ - _ _ - _ _ _ _  Last Date of Attendance: _______
Name/Address While in Attendance:
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Signature: _________________________________________________

Please send an original with your signature to each college/university you attended.