"Transcript Request Form - Portland Community College"

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Mail Form To:
Enrollment Services
Transcript Request
Enrollment Services
Phone: 971-722-8888, Option 2
SY CC 208
Sylvania Fax: 971-722-4988
P.O. Box 19210
Rock Creek Fax: 971-722-7419
Portland Community College
Portland, OR 97280-0210
Cascade Fax: 971-722-5410
Southeast Fax: 971-722-6336
PLEASE FILL OUT THIS FORM COMPLETELY
Missing information may affect or delay your transcript request
YOUR INFORMATION (PRINT CLEARLY)
_______________________________________________________
______________________
Last Name
First Name
Middle Name
Student ID #
Other names known at PCC
__________________________________________
Check here if this is a new address or phone
Special Instructions:
Hold for end of term grades/GPA.
_______________________________________________________________________
Hold until degree is posted.
Street Address
I will pick up at (select location):
o Cascade, number of copies _____
_______________________________________________________________________
o Rock Creek, number of
City, State & Zip
copies_____
o Southeast, number of
_______________________________________________________________________
copies_____
Telephone
o Sylvania, number of copies_____
Include CEU credits
_______________________________________________________________________
Date of Birth
SEND OFFICIAL TRANSCRIPTS TO (maximum request of 3 transcripts per day):
Number of Copies ________
Number of Copies ________
Check if address is same as above
____________________________________________________________
____________________________________________________________
Name
Name
____________________________________________________________
____________________________________________________________
Address
Address
____________________________________________________________
____________________________________________________________
City, State & Zip
City, State & Zip
I authorize PCC to release my transcripts to the addresses indicated above.
___________________________________________________________________
_________________________________
Student signature (REQUIRED)
Date
Please allow a minimum of 3-5 business days for processing. Allow
FOR PCC OFFICE USE ONLY
additional time during peak periods such as registration, start of
# of copies _______ ID ______
term, final grade posting and degree posting.
PCC cannot release transcripts from other schools.
Amount _________ ID ______
Transcripts cannot be released if there is a financial hold on your
account.
Receipt _________ID_______
Up to three (3) transcripts per day will be provided free of charge.
Mail Form To:
Enrollment Services
Transcript Request
Enrollment Services
Phone: 971-722-8888, Option 2
SY CC 208
Sylvania Fax: 971-722-4988
P.O. Box 19210
Rock Creek Fax: 971-722-7419
Portland Community College
Portland, OR 97280-0210
Cascade Fax: 971-722-5410
Southeast Fax: 971-722-6336
PLEASE FILL OUT THIS FORM COMPLETELY
Missing information may affect or delay your transcript request
YOUR INFORMATION (PRINT CLEARLY)
_______________________________________________________
______________________
Last Name
First Name
Middle Name
Student ID #
Other names known at PCC
__________________________________________
Check here if this is a new address or phone
Special Instructions:
Hold for end of term grades/GPA.
_______________________________________________________________________
Hold until degree is posted.
Street Address
I will pick up at (select location):
o Cascade, number of copies _____
_______________________________________________________________________
o Rock Creek, number of
City, State & Zip
copies_____
o Southeast, number of
_______________________________________________________________________
copies_____
Telephone
o Sylvania, number of copies_____
Include CEU credits
_______________________________________________________________________
Date of Birth
SEND OFFICIAL TRANSCRIPTS TO (maximum request of 3 transcripts per day):
Number of Copies ________
Number of Copies ________
Check if address is same as above
____________________________________________________________
____________________________________________________________
Name
Name
____________________________________________________________
____________________________________________________________
Address
Address
____________________________________________________________
____________________________________________________________
City, State & Zip
City, State & Zip
I authorize PCC to release my transcripts to the addresses indicated above.
___________________________________________________________________
_________________________________
Student signature (REQUIRED)
Date
Please allow a minimum of 3-5 business days for processing. Allow
FOR PCC OFFICE USE ONLY
additional time during peak periods such as registration, start of
# of copies _______ ID ______
term, final grade posting and degree posting.
PCC cannot release transcripts from other schools.
Amount _________ ID ______
Transcripts cannot be released if there is a financial hold on your
account.
Receipt _________ID_______
Up to three (3) transcripts per day will be provided free of charge.