Transcript request - Copiah–Lincoln Community College

Office of Admissions and Records, P.O. Box 371, Wesson, MS 39191 Fax (601) 643-8225

E-mail laci.renfroe@colin.edu OR gay.langham@colin.edu

Transcript Request

*Print Name and Address: _______________________________________ _______________________________________ _______________________________________

*ID# or SS#______________________________ Current Co-Lin Student? Yes ? No ? Dates of Attendance:______________________

*Phone Number:_________________________ *Send Transcript to: _______________________________________ _______________________________________ _______________________________________ _______________________________________ *Required Information: Official transcripts can be mailed, e-scripted, or picked up for $2.00 each. The first official transcript is free. All faxed transcripts are $5.00 each and unofficial.

Check for First Official Sent: ? Payment: Cash ? Check ? Credit Card ? Credit Card No.:__________________________ Expiration Date:__________________________ Credit Card Billing Zip:_____________________ 3-Digit security code:______________________ Send Now: ? Hold for Final Grades ?

I understand that, pursuant to rights contained in the Family Education Rights and Privacy Act of 1974, any information released to the above institution or individual will not be released to any other party without the written consent of the above named student.

I have been given the opportunity to challenge the contents of my school records to insure that the school records are not inaccurate, misleading or otherwise in violation of my privacy or other rights and have been provided an opportunity for the correction or deletion of any such inaccurate, misleading, or otherwise inappropriate data contained therein.

PLEASE READ CAREFULLY!

If your record has been encumbered by financial indebtedness or admission requirements have not been met, no transcript can be issued until the obligation has been cleared.

High School transcripts CANNOT BE RELEASED by this office. Please contact your high school.

TRANSCRIPTS FROM OTHER COLLEGES or UNIVERSITIES that have been sent to our office for our files CANNOT BE COPIED. Additional copies must be obtained directly from the schools.

Students' records are confidential and transcripts issued only at the written request signed by the student.

Signed:___________________________________________________ Date:_____________________________________________ *(SIGNATURE REQUIRED)

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