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Enrollment transcriptRequestFormICC

This transcript request form allows students to request copies of their transcript from Illinois Central College. Students must provide their personal information, dates of attendance, the number of copies needed, the address where the transcripts should be sent, and their signature authorizing the release of the transcript. They also specify whether the transcript should be processed immediately, after grades or graduation are posted, or with other special instructions. There is a $2 fee per transcript copy. Transcripts will not be issued if the student has any unpaid obligations to the college.

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Benjamin Reynolds
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30 views

Enrollment transcriptRequestFormICC

This transcript request form allows students to request copies of their transcript from Illinois Central College. Students must provide their personal information, dates of attendance, the number of copies needed, the address where the transcripts should be sent, and their signature authorizing the release of the transcript. They also specify whether the transcript should be processed immediately, after grades or graduation are posted, or with other special instructions. There is a $2 fee per transcript copy. Transcripts will not be issued if the student has any unpaid obligations to the college.

Uploaded by

Benjamin Reynolds
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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After completing and signing this form, submit to Student Service Center, L211

Or mail with payment to:


Illinois Central College
East Peoria Campus
One College Drive
East Peoria, IL 61635-0001
(309) 694-5609

TRANSCRIPT REQUEST FORM

Date of Request: ___ ___ / ___ ___ / ___ ___ ___ ___ Number of copies requested: _____ WYW _____

Last 4 digits of SSN: ___ ___ ___ ___ ICC Student ID Number: ___ ___ ___ ___ ___ ___ ___

Name: _____________________________________________ WHEN SHOULD TRANSCRIPT BE PROCESSED?


Last First MI (Please indicate semester.)

Previous Names: ___________________________________ ‰ Now


‰ After ____________ grades are posted.
Street Address: _____________________________________
‰ After Graduation Certification is posted.
City, ST, Zip: ________________________________________ (Allow 6-8 weeks after the semester ends)
Telephone: (___________) ___________________________ ‰ Other instructions:
_________________________________________
Birthdate: ___ ___ / ___ ___ / ___ ___ ___ ___

DATES OF ATTENDANCE AT ICC: From ____________________ (Term/Year) to _________________________ (Term/Year)

THIS IS THE MAILING LABEL. STUDENT IS RESPONSIBLE FOR PROVIDING CORRECT ADDRESS.

NAME ___________________________________________________________________
DEPT. ____________________________________________________________________
ADDRESS _________________________________________________________________
CITY ______________________________ ST _________ ZIP CODE ___ ___ ___ ___ ___

Signature of student authorizing release of transcript: _____________________________________________ Date: ___________


The Family Educational Rights and Privacy Act of 1974 prohibits educational institutions from releasing student records WITHOUT written
consent from the student.

TRANSCRIPT PROCEDURES
1. A fee of $2.00 for each copy must accompany this request. Payments will be accepted by check or money order, payable to Illinois
Central College. Please do not send cash. “WHILE YOU WAIT” requests are charged a fee of $5.00 per copy.
2. Transcripts released to students will be stamped “ISSUED TO STUDENT”. These may not be accepted as official.
3. ICC does not accept requests for transcripts to be faxed to other agencies or institutions.
3. Transcripts will not be issued until all monetary holds are cleared with Student Accounting.
4. If sending transcripts to more than one recipient, please use a separate form for each transcript request.
5. Please mail this form with payment to the address listed at the top of this request.

FOR OFFICE USE ONLY


Amount Paid: $ ______________ Received By: ___________ Date Sent: ___ ___ / ___ ___ / ___ ___ ___ ___
WE ARE UNABLE TO RELEASE YOUR TRANSCRIPT FOR THE FOLLOWING REASON(S):
____ Unpaid obligation (Contact Student Accounting. 694-5467) ____ Library Fine (Contact Library 694-8463)
____ Traffic Fine (Contact Student Accounting. 694-5467) ____ Need Student ID Number/SSN verification
____ Need $2.00 Fee per Transcript ____ Other ________________________________________

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