Orange County Community College
Transcript Request Form
# Please complete a separate request for each address where you wish a transcript sent.
# Print and Mail, with $5.00 fee per transcript to:
Orange County Community College
Attn: Records & Registration / Transcripts
George F. Shepard Student Center, 3
rd
Floor
115 South Street
Middletown, NY 10940
# Records and Registration Phone (845) 341-4155 FAX: (845) 342-8662
Your name: (please print)_____________________________________________________________________
Your address: ______________________________________________________________________________
__________________________________________________________________________________________
Your social security #:_______-_______-_______
Name and /or office (including address) where you want the transcript sent. (Include zip code!)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
How many transcripts shall we send?________________________ Today’s date: ________________________
Your signature:_____________________________________________________________________________
When do you want the transcript sent? _____ Now ____ After final grades posted for current semester
____ After degree posted for current semester
If Summer, after which of the following sessions do you want your transcript (s) sent:
Summer Session 1 _____ Summer Session 2 _____Summer Session 3 ______
Are you a graduate of SUNY Orange ? ______ Yes _____ No Month and Year ____________
Are you currently enrolled in SUNY Orange ______ Yes _____ No
Date of first enrollment at SUNY Orange _____________
If not currently enrolled, year in which you were last enrolled at SUNY Orange: _______________
Your date of birth: ______ Maiden/former name at college if applicable: ______________________________
Day phone: (please include area code) ( )
If paying by credit card please include the following:
Circle one: VISA / Discover / Master Card Credit Card #:____________________________
Name on Card:_____________________________________Expiration Date: __________________________
Signature: _____________________________________
* NOTE: Transcript requests are processed in the order in which they are received. Requests delivered in person or by
fax are not guaranteed to be processed any faster than two or three weeks.
* When you graduated did you fill out an extra curricular form? If Yes would you like this information to be included
with your transcript?________. This could only have been done at time of graduation.
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
