HIGH SCHOOL/COLLEGE TRANSCRIPT REQUEST
TO:
(Please print – do not abbreviate)
Social Security number:
Name:
Last First Middle (Full)
Maiden/previous name(s):
Street:
City: State: ZIP code: Phone:
Attended from: to Graduation date:
Month/year Month/year Month/year
I agree to pay the fee charged to send my transcript, if applicable.
Student’s signature authorizing release Date
Please mail an official coPy of my transcriPt to:
Kankakee Community College
Admissions and Registration
100 College Drive
Kankakee, IL 60901
City:
State:
Zip code:
( )