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Transcript Request Form

This document is an official transcript request form for Salt Lake Community College. It requests the student's personal information such as name, student ID or SSN, birthdate, years of attendance, and number of transcripts being ordered. The student can choose to pick up the transcript in person, have it sent immediately, or sent after certain criteria are met. The student signs to authorize SLCC to charge payment and release the transcript, which can be sent to other colleges, by fax, mail, or to a designated email. Payment of $5 per transcript is due by phone or with a mailed request. The form complies with FERPA and notes transcripts may be withheld due to holds on the student's record.

Uploaded by

Chris Teynor
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
32 views

Transcript Request Form

This document is an official transcript request form for Salt Lake Community College. It requests the student's personal information such as name, student ID or SSN, birthdate, years of attendance, and number of transcripts being ordered. The student can choose to pick up the transcript in person, have it sent immediately, or sent after certain criteria are met. The student signs to authorize SLCC to charge payment and release the transcript, which can be sent to other colleges, by fax, mail, or to a designated email. Payment of $5 per transcript is due by phone or with a mailed request. The form complies with FERPA and notes transcripts may be withheld due to holds on the student's record.

Uploaded by

Chris Teynor
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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OFFICIAL TRANSCRIPT REQUEST

PLEASE PRINT CLEARLY: SID # _________________________ or SSN (Optional) ___________________ NAME ___________________________________________________________
LAST FIRST MIDDLE

PURPOSE OF TRANSCRIPT: ACADEMIC PURPOSE EMPLOYMENT OTHER


SEND OFFICIAL ELECTRONIC TRANSCRIPT TO:

FORMER NAME(S) ________________________________________________ ADDRESS ________________________________________________________ CITY ________________________________ STATE ______ZIP ___________ PHONE (_______)__________________________________________________ BIRTH DATE _____________________________________________________ APPROXIMATE YEAR OF ATTENDANCE ____________________________ TOTAL # OF TRANSCRIPTS ORDERED_____ Choose one: Pick up in person # ____ Send immediately # ____ Send after current grades are available _____________ (semester & year) Send after degree is posted _____________ (semester & year)
I AUTHORIZE SLCC TO CHARGE PAYMENT AND RELEASE A COPY OF MY TRANSCRIPT(S)

UNIVERSITY OF UTAH BRIGHAM YOUNG UNIVERSITY SOUTHERN UTAH UNIVERSITY SNOW COLLEGE WESTMINSTER COLLEGE WESTERN GOVERNORS UNIVERSITY

UTAH VALLEY UNIVERSITY UTAH STATE UNIVERSITY WEBER STATE UNIVERSITY COLLEGE OF EASTERN UTAH DIXIE STATE COLLEGE UNIVERSITY OF PHOENIX

OR SEND FAXED OR MAILED TRANSCRIPT TO:

$5.00 IS CHARGED FOR EACH TRANSCRIPT PROCESSED.


Please choose one of the following payment options:

TODAYS DATE ____________ STUDENT SIGNATURE ___________________________________________

Pay over the phone to cashier: (801) 957-4868. Confirmation # ___________ Payment included with mailed request.

Send this completed and signed transcript request form to:

PLEASE NOTE: If a hold has been placed on your record, a transcript will not be issued until the hold has been cleared. This form complies with the Family Educational Rights and Privacy Act.

FAX NUMBER: 801-957-4961 SALT LAKE COMMUNITY COLLEGE


EMAIL: [email protected] ENROLLMENT SERVICES P. O BOX 30808 SALT LAKE CITY, UTAH 84130-0808

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