Rev. August 2017 

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FLETC Transcript Request Form

For Agency Specific Programs, please

refer to the “Request Your FLETC Transcripts”

page for specific agency contacts.

Fletc.gov/transcripts

Mail To: Transcript Requests, Educational Aides 

Federal Law Enforcement TrainingCenters 

1131 Chapel Crossing Rd., Bldg. 681

Glynco, GA 31524

PleaseE-mailcompletedform

to:

fletc-transcripts@dhs.gov

PRINTED NAME SSN 

See page 2 for Availability of Syllabi, Penalty under 5 U.S.C. 552a (i) (3) and Privacy ActNotices 

Please check all that apply:

Self College or University Employer 

*Self-copies requested will be E-mailed to the address providedbelow.

CLASS(S) YEAR(S) ATTENDED: 

As a service, we will send transcripts of grades and program syllabi, if available, to colleges, universities, and/or 

employers at the request of our former students. There is no charge for thisservice.

The college or university will determine how many, if any, credits they will allow for your FLETC training. The 

FLETC does not assign credit hours for our training programs.

If you are requesting a transcript for a college, university, and/or employer, you must provide theirmailing

address below. Please include the name of your contact if you haveone.

This is to verify that I am the individual who is the subject of the records requested and that my addressis:

ADDRESS 

CITY STATE ZIP 

*Email Address 

Daytime phone number should there be any questions regarding yourrequest 

I understand the penalties provided in 5 U.S.C.552a (i) (3) for requesting or obtaining access to records under false 

pretenses. I certify under penalty of perjury pursuant to 28 U.S.C.1746 that the foregoing is true and correct.

SIGNATURE DATE 

You must sign this request and include with it a legible copy of a signed official picture ID.

Copy of Signed Official 

Picture ID Goes

Here
March 2017

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NOTICE: Most training programs lasting two weeks or less do not have asyllabus.

Penalty under 5 U.S.C. 552a (i) (3)

Any person who knowingly and willfully requests or obtains any record concerning an individual from an 

Agency under false pretenses shall be guilty of a misdemeanor and fined not more than $5,000. 

Additionally, while not specified in the law, the individual whose privacy is violated can seek civil 

damages against the person who requested the records under false pretenses.

PRIVACY ACT NOTICE

The authority to collect the information is derived from the Government Employees Training Act, 5 

USC 4101 4118 as implemented by Executive Order 11348 of April 20, 1969 and Reorganizing Plan 

No. 26 of 1950 and the Treasury Department Order No. 140-01 (Federal Law Enforcement Training 

Centers), and Memorandum of Understanding for the Sponsorship and Operation of the 

Consolidated Federal law Enforcement Training Centers. The information you supply will be used 

to assist the government in retrieving information documenting your training. If you furnish none of the 

information requested, the government will be unable to process your request. If you furnish only part

of the information required, an attempt will be made to process your request. If the information withheld 

is found to be essential to effectively locating your records, you will be so informed . Disclosure by

you of your Social Security Number (SSN) is mandatory. Solicitation of the SSN is authorized under

the provisions of Executive Order 9397 dated November 23, 1943. The SSN will be used only as 

necessary in connection with retrieving your records. The use of the SSN is made necessary because of

the large number of present and former Federal employees who attend or have attended Center

Programs, and who potentially may have identical names and birth dates and whose identities can only 

be distinguished by the SSN.

NOTE: Transcript requests are processed on a first-come, first-served basis. The average 

processing time for transcript requests is four weeks.