TRANSCRIPT REQUEST FORM - Fort Peck Community College

Fort Peck Community College 605 Indian Avenue Po Box 398 Poplar MT 59255

TRANSCRIPT REQUEST FORM

Phone: (406) 768 ? 6300 Fax: (406) 768 ? 6301 fpcc.edu

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STUDENT INFORMATION:

Name:____________________________________ Mailing Address:___________________________ _________________________________________ Phone Number:____________________________ Email Address:_____________________________

SSN:______________________________________ Maiden name or other names used: __________________________________________ Dates Attended: __________________________________________

TYPE OF TRANSCRIPT REQUESTED: _____Official ($5 Fee) _____Unofficial _____Total number of copies requested

OFFICE USE ONLY: Date request received _______________________ Date request processed______________________ Fee paid___________________________________

INSTRUCTIONS: _____ Mail _____ Fax **Unofficial by default**

**CAN ONLY BE FAXED TO A MT COLLEGE OR UNIVERSITY**

_____ Pickup

_____ Send transcript now _____Send transcript after this term _____Send transcript now & after term

MAIL OR FAX TO:

Student account must be clear before transcripts may be sent. There is a charge per transcript for official transcripts. Faxed transcripts are unofficial. Must have proof of high school graduation or GED/HiSet completion in student file. Payment of transcript fee must accompany request.

____________________________________________ ______________________________________

Student Signature

Date

Transcript fees and related charges are as follows:

Unofficial Transcripts

FREE

Official Transcripts

$5.00/copy

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