Request for Transcript Form - Copper Mountain College



Request for Unofficial Transcript (Grades) Form

Please Complete, Print and Fax or Email

First Name* _______________________________________________________ Middle Initial ______

Last Name* _________________________________________________________________________

Former Name(s) _________________________________________________________________________

Address 1* _________________________________________________________________________

Address 2 _________________________________________________________________________

City* _____________________________________ State* _________ Zip* ________________

Day Phone* ______________ - ____________ - ____________

Last 4 of SSN* _________________ OR Coyote Tracks ID#: __________________

Date of Birth* ____________ / ____________ / ____________ MM/DD/YYYY

Unofficial Transcript for CMC Grades (Free) 3-5 business days

You may choose to have your grades emailed OR faxed to you:

Fax # (Unofficial Transcript (Grades) Only) OR

Email:

Please note: We are unable send international faxes. If you are at an international location, to receive your unofficial transcript via email, please provide your email address above.

Signature: ____________________________________________________ Date: ____________________

Mail: Copper Mountain College Fax: 760-830-4157 Questions: 760-830-6133

Base Programs Office Email: unofficialtranscriptrequest@cmccd.edu

Unofficial Transcripts

P.O. Box 1398

Joshua Tree, CA 92252 REV 12/15

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