TODAYS DATE:______

Transcript Request Form

Name: ______

Graduation Year:______

Student ID#______

Phone# ______

Email Address:______

Date of Birth (MM/DD/YY):______

PLEASE READ CAREFULLY

Directions: Return this completed form to the Registration office #135. The cost for each transcript is $2.00. The transcript can be mailed directly to the College, University or Scholarship. Also, you can pick up the final transcript in the Registration office.

SELECT ONE MAIL PICK-UP

College, University or Scholarship

Name______

Address______

Zip Code______State______

PLEASE ALLOW ONE WEEK FOR PROCESSING AND ATTACH THE $2.00 FOR EACH TRANSCRIPT REQUESTED TO THIS FORM

OFFICE USE ONLY

Transcripts Requested: ______Total Cost: ______Date Paid: ______Date Ordered: ______

TODAYS DATE:______

Electronic Transcript Request Form

Name: ______

Student ID#______

Phone# ______

Email Address:______

Date of Birth (MM/DD/YY):______

PLEASE READ CAREFULLY

Directions: Return this completed form with selected College or University below. There is no fee for Electronic Transcripts. PLEASE NOTE in order to process an electronic transcript request, your social security number MUST ALREADY be on file with our school. (Place an "X" in the empty box by selected school name)

Indian River CC 00C911 Florida Gulf Coast University Ft. Myers 00U979 Florida International University (FIU) 00U990 Florida State University Tallahassee 00U973 Coral Gables 730000000153600 Orlando 730000000153600 University of Tampa 730000000153700 University of Central Florida Florida 730000000395400 Miami 730000000146600 Florida Atlantic University Boca Raton 730000000148100 Florida 00C100 Miami Dade College NORTH 00C929 Miami Dade College WOLFSON 00C931 Miami Dade College MEDICAL 00C932 Miami Dade College SOUTH 00C930 Palm Beach College West Palm 00C918 Santa Fe Community College Gainesville 00C924 Seminole Community College Sanford 00C925 Central Ocala 00C950 University of Florida Gainesville 00U988 Florida Agricultural and Mechanical Main Campus 730000000148000 St. Thomas University Florida 730000000146800 Florida Memorial College Florida 730000000148600 Jacksonville University Florida 730000000149500 Albany State University Georgia 730000000154400