"Request for Official Transcript - Columbia-Greene Community College"

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Columbia-Greene Community College
Attn: Records
4400 Rte 23
Hudson NY 12534
518-828-4181 ext. 5514
REQUEST FOR OFFICIAL TRANSCRIPT
Date:
/
/
SSN OR
Name:
Student ID:
-
-
Address:
Choose one option from the list below:
 Send immediately.
 Send after incomplete grade is changed
Phone:
 Send when grades are available from
previous semester (indicate below):
PRINT your name, complete address and daytime phone number in
 Fall
 Spring
 Summer
the area above.
$5.00 per official transcript.
I authorize Columbia-Greene Community College to send my college transcript to
Mail transcript request or fax to 518-822-2015.
the parties listed below.
If faxing request, please include credit card
Student's
information. Otherwise you may pay by check
Signature:
or money order.
For official copy PRINT the name & address of the recipient of the transcript in
the block below. Be sure to include the appropriate office and/or individual the
Maiden or other Name at CGCC:
transcript must reach and indicate how many copies are needed.
FOR OFFICE USE ONLY
DO NOT WRITE BELOW THIS LINE
# OFFICIAL:
x $ 5.00 EACH
AMOUNT DUE:
How Many?
R/R INITIALS:
RECEIPT #:
DATE SENT:
How Many?
F
O
U
O
:
OR
FFICE
SE
NLY
How Many?
Columbia-Greene Community College
Attn: Records
4400 Rte 23
Hudson NY 12534
518-828-4181 ext. 5514
REQUEST FOR OFFICIAL TRANSCRIPT
Date:
/
/
SSN OR
Name:
Student ID:
-
-
Address:
Choose one option from the list below:
 Send immediately.
 Send after incomplete grade is changed
Phone:
 Send when grades are available from
previous semester (indicate below):
PRINT your name, complete address and daytime phone number in
 Fall
 Spring
 Summer
the area above.
$5.00 per official transcript.
I authorize Columbia-Greene Community College to send my college transcript to
Mail transcript request or fax to 518-822-2015.
the parties listed below.
If faxing request, please include credit card
Student's
information. Otherwise you may pay by check
Signature:
or money order.
For official copy PRINT the name & address of the recipient of the transcript in
the block below. Be sure to include the appropriate office and/or individual the
Maiden or other Name at CGCC:
transcript must reach and indicate how many copies are needed.
FOR OFFICE USE ONLY
DO NOT WRITE BELOW THIS LINE
# OFFICIAL:
x $ 5.00 EACH
AMOUNT DUE:
How Many?
R/R INITIALS:
RECEIPT #:
DATE SENT:
How Many?
F
O
U
O
:
OR
FFICE
SE
NLY
How Many?
complete
forward this form to the College
To pay by
I,
authorize Columbia-Greene Community College to
(Print Cardholder's Name)
to my
Am
Ex
Student ID:
Tuition/Fees for:
C/C#:
VCODE:
Card Expires:
Billing Address:
Cardholders Signature
and/or Telephone #:
Date:
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