v.

13/05/2016

Academic year:
URV.E11.00.00

APPLICATION FOR THE ISSUANCE OF THE PERSONAL ACADEMIC

TRANSCRIPT

PERSONAL INFORMATION
Name: First surname: Second surname:

Identity card number (or passport number): Address for written correspondence:

Postcode: Town: Telephone:

Mobile telephone: URV e-mail address:

Course:

I REQUEST

That you issue me with my personal academic transcript in accordance with the URV's standard format.

Indicate in which language/s you want your personal academic transcript to be issued.
Catalan Spanish English

[place] __________________________, [date] _________________________________

(signature)

Head of the Secretary's Office of the Faculty/School

I have received the personal academic transcript that I

requested.
[place] __________________________, [date]
_________________________________
(signature)

In compliance with Article 5 of Organic Law 15/1999, of 13 December, on Personal Data Protection, we inform you that the data provided by you will be stored and handled in a file held by
the Academic Management Service with the aim of managing your academic record and organizing your tuition and studies. These data will be passed onto the Spanish Ministry of Education,
the University and Research Grants Management Service, the Qualifications Service of the Ministry of Education, the centres affiliated to the URV, the CESCA and the Admissions Guidance
Office of the University. They may also be ceded to third parties in the circumstances specified by the relevant legislation.

The individual responsible for this file is the General Manager of the Universitat Rovira i Virgili, who is based in Tarragona at Carrer de lEscorxador, s/n. Under the existing law, you have the
right to access, rectify and, if necessary, remove your data and to appeal against their being handled. To exercise this right, you must submit a written request addressed to the Academic
Management Service either in person to the Registry of the URV at Carrer de l'Excorxador, s/n - 43003 Tarragona, or online at https://seuelectronica.urv.cat/registre.html
v.13/05/2016

Academic year:
URV.E11.00.00

Student details

Full name:

Identity card number:

Address for written correspondence:

Post code: Town:

Course:

RESOLUTION OF THE APPLICATION FOR THE ISSUANCE OF THE PERSONAL

ACADEMIC TRANSCRIPT

Stamp of Faculty/School

The application is rejected because:

[place] __________________________,
,,yjgfgfhg [date] _________________________________

This decision is not the end of the administrative process and, should students wish to do so, they can appeal to the rector of the
URV within one month of having been informed of this decision.