MONTCALM COMMUNITY COLLEGE

Transcript Request

General Information

1.  The first three transcripts are issued without charge.
     Additional copies cost $1.00 each.
2.  Transcript will not be processed if there is a college debt.

3.  Only unofficial copies of transcripts will be issued to the student.       
     Official copies will be mailed directly to another institution or employer.

PLEASE PRINT ALL INFORMATION:

Name ____________________________________________________________________________
                        Last                                                                        First                                        MI                                        Former

Address __________________________________________________________________________

             __________________________________________________________________________

Last 4 Numbers of Social Security Number ______________

Currently enrolled?   _____Yes  _____No   If not, last semester of attendance _____________________

Check all of the following which apply to this request:

        _____ Mail as soon as possible
        _____ Hold for current semester grades
        _____ Hold until degree or certificate is posted

Name and address where transcript is to be sent:

_________________________________________________                    __________________
                                                                                                                               Office Use
_________________________________________________                    Date Sent __________

_________________________________________________                    Staff Initials _________

Number of copies to be sent ___________________________

We are bound by the Family Educational Rights and Privacy Act of 1974 not to release any information without the student's written authorization.

_________________________________________________                    _________________
Student's signature                                                                                                                            Date

Please mail this form to Enrollment Services, Montcalm Community College, 2800 College Drive, Sidney, MI 48885, or, fax it to 989-328-2950 attn: Enrollment Services.