Transcript Request Form

Transcript Request Form
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Personal E-mail Address*
example@example.com
Social Security Number*
Please Release a Copy of My Transcripts to:
Office or Department:*
Name of Institution*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Address*
To the Attention of:
Is this your first transcript request?*

YesNo
Transcript Fee: No charge for first copy of transcript requested; $10.00 for each subsequent copy.
Signature (Use your mouse cursor to sign)*
Date*

MonthDayYear
A transcript will not be released until all financial obligations to Southern Methodist College has been satisfied.

Trasncript Fee

USDor mail to Southern Methodist College at 541 Broughton St. Orangeburg, SC 29115