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ADEA AADSAS Transcript Matching Form

For 2011 Entering Class
Instructions to the Applicant:
To assure prompt handling, complete the ADEA AADSAS Transcript Matching Form. Print the form and
submit it to your school’s Registrar.
*Required field
*Current Legal Name: ___________________________________________
Santos, Chareen Nicole T
Institution: ___________________________________________________
UNIVERSITY OF CALIFORNIA - RIVERSIDE
_____________________________________________________
_____________________________________________________

*Former Name Used While Enrolled in the Institution

Last: ________________________________________
Middle: ________________________________________
First: ________________________________________
Suffix: ________________________________________

*ADEA AADSAS ID Number: ____________________________________

20110227344

* DENTPIN® ID Number: ______________________________________

12835888

*Date of Birth (MM/DD/YYYY): ____________________________________

03/13/1986

*Full Name of Institution: ________________________________________

Campus Attended: ____________________________________________

*Dates of Attendance: __________________________________________

Degree (if applicable): __________________________________________

*Does this Transcript contain Fall 2010 grades? ____________________

*Is this form being submitted because of your grade change on your transcript?

*Applicant’s signature: _________________________ Date: __________________

Instructions to the Registrar:
Please attach this form to the sealed official transcript for the above applicant and forward directly to:
AADSAS Transcript Processing Center
P.O. Box 9110
Watertown, MA 02471

If you would like to express mail your transcripts send to:

AADSAS Transcript Processing Center
c/o Liaison International
311 Arsenal Street
Watertown, MA 02472
The transcript must meet the following requirements to be considered “official” by ADEA AADSAS.
• Registrar’s seal and/or legible signature included on transcript
• Be received directly from the Registrar’s office
• Transcript NOT marked “issued to the student” or “student copy”