Columbia College Transcript Request Form

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OFFICIAL TRANSCRIPT REQUEST FORM
 
STUDENT INFORMATION
 
 
 
 
Print Student's Full Name
Name(s) While Attending
COSTS:
Current Permanent Address / Apt. #
Payment of the $10.00 per transcript processing fee is
required prior to the release of all transcripts. Transcripts cannot be
l
provided if you have a financial hold with the college.
City, State, Zip
E-mail
PRIVACY:
Student records are confidential, and transcripts are
l
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Home Phone
Cell Phone
Work Phone
issued only at the written request of the student. Telephone requests
are not accepted.
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TRANSCRIPTS FROM OTHER SCHOOLS:
Columbia College is
SSN or Columbia College ID number
Birth Date (mo/day/yr)
unable to release transcripts received from other colleges or
 
universities. Additional copies must be obtained directly from the
Last attended (year):
issuing institution.
Purpose of Request:
TRANSCRIPTS ISSUED TO STUDENT:
A transcript is a complete
 Transfer
 Employment
 Scholarship Application
copy of the student’s academic record. Official transcripts bear the
College seal and the signature of the Registrar. If a transcript is sent
 Graduate School
 Personal Use
 Other_____________
directly to a student, the words “Issued to Student” will appear on the
transcript.
Type of Transcript:
Undergraduate*
Masters*
ELECTRONIC TRANSCRIPTS:
Columbia College sends official
*Students with undergraduate and graduate courses receive both transcripts for one fee
transcripts electronically through the eSCRIP-SAFE secure network.
The recipient will receive an email from eSCRIP-SAFE containing a
Hold for current term grades
Hold until degree is posted
Do Not Hold
link where they may view and download your transcript in PDF format.
The receiving party determines whether they will accept it as official.
 
Prior to requesting, be certain the intended recipient is aware of the
 
delivery method and will accept this format as official.
 
Mail Transcript
:
                 
 
 
(Allow 5 business days for processing)       
Send completed and signed form to:
Quantity
       
 
 
Columbia College
 
Office of the Registrar - Transcripts
 
1001 Rogers Street
 
Columbia, MO 65216
 
Fax to: (573) 875-7436
Scan and Email to:
transcripts@ccis.edu
 
 
Send Transcript Electronically:
 
(Allow 5 business days for processing)
 
 Organization is within SCRIP-SAFE network (
 
Inquire at your school)
Payment Information
_____________________________
 
A charge of $10.00 is made for each transcript (including transcripts sent
School Name
electronically). Payment must accompany request.
 
Check/Money Order Enclosed
 Organization is outside SCRIP-SAFE network
(Do not mail cash)
 
__________________________________
Visa
MasterCard
Discover
 
Recipient’s First Name
Recipient’s Last Name
Card Number
______________________________
 
 
 
Recipient’s Email Address
Exp. Date ___/___
 
CVC code (REQUIRED)
(3-digit number on back of card)
 
 
 
X
STUDENT’S SIGNATURE
Date
This signature is required to authorize the release of your transcript to the party listed above and to charge your credit card payment when applicable.
Computer-generated signatures are not valid.
For internal use only: Date received __________________ Account clearance ____________ Payment made ____________ Sent ___________

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