Suffolk County Community College Transcript Request Form printable pdf download

Suffolk County Community College Transcript Request Form

UFFOLK

OUNTY

OMMUNITY

OLLEGE

Transcript Request Form

Rev 04/14

Last Name

First Name

Note: This request cannot be honored until your

obligations (if any) to the College have been met.

Name while attending SCCC

Home Campus: ___ A ___ E ___ G

___ Send ASAP

___ Hold for final grades/graduation

___ Check if transcript is going to a SUNY school

___ Hold for grade changes–indicate courses: __________

Student's Current Address:

Print name and address to which transcript is to be sent:

Attention:

Telephone Number:

Student’s Signature:

Date:

___ /___

Student ID (or last four of your SSN): _________________

Date of Birth (Month/Day):

INSTRUCTIONS:

Complete one form for each transcript requested.

Return completed form(s) to your campus Cashier's Office, where you will pay a $10.00 fee for each transcript requested. If you are currently

enrolled, you must present your SCCC ID card in order for your request(s) to be processed. If you are not enrolled, you may use your driver's

license.

If returning form(s) by mail, you must send a check or money order payable to Suffolk County Community College ($10.00 for each transcript)

along with a photocopy of your driver's license.

Mail to: PO BOX 1126, SUFFOLK COUNTY COMMUNITY COLLEGE, SELDEN NY 11784-0926.

Suffolk County Community College Transcript Request Form