FENNELLCAMPUS
BRANTFORDCAMPUS
STARRTCAMPUS
IAHSCAMPUS
TRANSCRIPTREQUESTFORM
THESQUARESTUDENTSERVICES
STUDENTSERVICES
STUDENTSERVICES
STUDENTSERVICES
135 Fennell Ave W., Hamilton, ON L8N 3T2
Tel.: 905-575-2000
411 Elgin St., Brantford, ON N3T5V2
Tel.: 519-758-6014
481 Barton St., Stoney Creek, ON L8E 2L7
Tel.: 905-575-1212 ext. 5021
1400 Main St W., Hamilton, ON L8S1C7
Tel.: 905-540-4247
Fax:
9055752109
SECTIONAPersonalInformation
NAME:[FIRST,MIDDLE,LAST]
STUDENT#:
PREVIOUSNAME(IFAPPLICABLE):
STREETADDRESS:CITY:PROVINCE:
POSTALCODE:
DATEOFBIRTH:
EMAILADDRESS:
HOMEPHONE#:
ALTERNATEPHONE#:
SECTIONBStudentRecordandGraduationInformation
Program/Course:
Campus
YearsAttended:
Graduated:NoYesYearofgraduation________
From________To________
Program/Course:
Campus
YearsAttended:
From________To________
Program/Course:
Campus
YearsAttended:
From________To________
Graduated:NoYesYearofgraduation________
Graduated:NoYesYearofgraduation________
PleaseAllow5to7BusinessDaysforProcessing
SECTIONCTranscriptsRequired
NumberofTranscriptsRequired:________
SendNowSendafterFinalGradesrecordedSendafterConvocation*
*TranscriptswillnotstateDiploma/Certificate
Awardeduntilaftertheconvocationceremony.
Printforpickupat__________________Campus
Faxto:_________________________
(name/organization)
_________________________
(faxnumberfaxedcopiesarenotofficial)
1.Thereisnofeeforprocessingtranscriptrequests.
2.Transcriptrequestsareonlyacceptedinperson,bymail,orbyfax,
asyoursignatureisrequired.
3.Youareresponsiblefortheaccuracyofallinformationonthisform.
4.Itisyourresponsibilitytoreviewyouracademicrecordforaccuracy.
5.Transcriptswillonlybereleasedforpickupuponpresentationofappropriate
IDorasignedletterofpermission.
6.Transcriptswillnotbereleasedforstudentswhohaveoutstandingliabilities
withtheCollege.
Mailto:HomeAddress
Institution(s)/Organization(s)listedbelow:
(forcolleges/universitieswithinOntario,includeyourreference#;forinstitutionsoutsideOntario,includemailingaddress)
*Pleaseincludeadditionalsheetsifinsufficientspace*
SIGNATURE:
DATE:
FOR OFFICE USE ONLY
DATEPROCESSED:_____________________PROCESSEDBY:____________MailedFaxedReadyforpickupat_____________
Updated:October2011(initials)