Request for Adult Program Transcript/Records

Request for Adult Program Transcript/Records

Transcripts/records will generally be provided at no charge; however, if you request multiple copies or it requires significant staff time, staff may contact you regarding a charge. Please note, this request is for ADULT SCCC students who completed a program at SCCC. If you attended as a high school student, contact your high school counselor.
Your Name: *

First Name Middle Name Last Name Suffix
If your name was different while attending SCCC, please put those names here:
Leave blank if not applicable
Your Current Email Address: *
example@example.com
Your Current Phone Number: *
Please enter a valid phone number.
Your Date of Birth: *

Month Day Year
Date
Your Current Mailing Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Your SCCC Program *
If you select "Other," you will need to list the program name in the Notes section below.
Notes for SCCC Staff (if applicable)
Enter program name if not in the drop box above. Also, any other information that could help the staff process this request can be entered here.
Date You Began Your Program (can be estimated): *

Month Day Year
Date
Date You Completed Your Program (can be estimated): *

Month Day Year
Date
I am requesting an: *

Official Transcript (required at most colleges and universities) Unofficial Transcript Other Non-Transcript Record
I authorize a copy of my transcript to be sent to (name of school, employer, self): *
To the attention of: *
If unsure of the individual, put a generic department like "Human Resources" or "Registration & Records".
I prefer the transcript to be sent via:

U.S. Mail (must select this option for an Official Transcript) Fax (Note: this is not an official transcript) Email (Note: this is not an official transcript) In-Person pick up at SCCC
At this address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number of Transcript Recipient
Please enter a valid phone number.
Fax Number of Transcript Recipient (if applicable)
Please enter a valid phone number.
Email of Transcript Recipient (if applicable)
example@example.com
Acknowledgment

I swear that the information contained on this request is true and correct to the best of my knowledge. I confirm with my signature below that I am the current or former student listed above and hereby request South Central Career Center to disclose my confidential student records to any third-party listed above.

I understand that requests are generally completed within five business days, but may take up to 45 days.
Signature and Agreement *

Clear
Current Date: *

Month Day Year
Date

Request for Adult Program Transcript/Records

Transcript Request Staff Approval/Denial