Transcript Request Form
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1Transcript Request Form
THIS FORM MUST BE SIGNED,
PRINTED
AND
SUBMITTED TO THE REGISTRAR
Transcripts will not be transmitted via e-mail. Transcripts are not released if there is an outstanding financial obligation to NMCC
STUDENT NAME___________________________________________NAME ATTENDED UNDER___________________________
ADDRESS_______________________________________CITY_________________________STATE____________ZIP_________
PHONE#_____________________________________EMAIL________________________________________________________
SSN# _________________________________
DATE OF BIRTH________________________________
CURRENTLY ENROLLED ___________YES ___________NO
ATTENDED PRIOR TO 1985______ Yes ________No
Official
Unofficial
NUMBER OF TRANSCRIPTS____________
DATES OF ATTENDANCE ___________________
Send Immediately ______ Hold for recording of current semester grades _________ Hold for degree posting ______
Official transcripts bear the college seal and signature of the registrar and are not issued to students.
Payment required before
processing. “Send to” information must be complete and include recipient name/institution, address,
city, state and zip code. Requests for faxing must include recipient name, recipient phone number and recipient fax number,
including full area code.
COSTS
$ FREE Standard processing (sent by US Mail) Allow 2-5 business days for processing.
_______
_______ $25.00 Expedited processing - processed within one working day of receipt of request (sent by standard mail)
_______ $75.00 Overnight delivery (sent via FedEx) in addition to the expedited processing fee
_______ $10.00 Faxed (a faxed copy is not official. It does not bear the college seal)
Card Number __________________________________
___________________________________________
Name as it appears on card
Expiration date _________
_________
CSC
_______________ (
(mos)
(year)
(card security code)
last 3 numbers on signature line)
Sign here
__________________________________________________________________________________Date______________________________________
A hand-written signature
is required
for the release of transcripts. I authorize the release of my transcript to the individual or organization below.
Please enter the exact mailing address of where you want your transcript sent:
Name_____________________________________________________________________________________________
Address___________________________________________________________________________________________
City, State, Zip______________________________________________________________________________________
Fax Number_______________________________________Contact Person_____________________________________
33 Edgemont Drive
Presque Isle, ME 04769
TEL: (207) 768-2787
FAX: (207) 768-2848
EMAIL: transcripts@nmcc.edu
I: registration: forms: Transcript request form: 6/16
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