HONOLULU COMMUNITY COLLEGE - RECORDS OFFICE
874 DILLINGHAM BOULEVARD | HONOLULU, HI 96817-4598
PHONE: (808) 845-9120 | FAX: (808) 847-9872
DIRECTIONS: FILL OUT A TRANSCRIPT REQUEST FORM FOR EVERY RECIPIENT. ENCLOSE THE APPROPRIATE PAYMENT. MAKE CHECKS PAYABLE TO THE UNIVERSITY OF HAWAII.
ADDITIONAL POSTAL FEES ARE CHARGED FOR TRANSCRIPTS SENT OUTSIDE OF THE U.S.A. DO NOT SEND CASH.
PRINT LAST NAME, FIRST NAME, MIDDLE INITIAL
OTHER NAME(S) USED
DATE OF BIRTH
ADDRESS
PHONE NUMBER
CITY
STATE
ZIP CODE
UH ID OR SOCIAL SECURITY NUMBER
SEND TRANSCRIPT TO: (ONE TRANSCRIPT REQUEST FORM PER ADDRESS)
REQUEST TYPE AND QUANTITY
No. of copies = ______ x $15 for RUSH* (within 24 hours)
No. of copies = ______ x $5 for REGULAR* (7 Business Days)
*MAILING TIME NOT INCLUDED
IF ADDRESSED TO STUDENT, DO YOU WANT IT IN A SEALED ENVELOPE TO SUBMIT
TO ANOTHER PARTY? YES NO
WHEN SHOULD TRANSCRIPTS BE PROCESSED?
[ ] NOW
[ ] AFTER (specify semester) _________________ GRADES ARE POSTED
[ ] AFTER DEGREE IS CONFERRED (allow 10 weeks after semester ends)
[ ] OTHER (specify) __________________________________________
All transcripts released to the student will be stamped, ISSUED TO STUDENT’. As these
transcripts bear the Honolulu Community College seal, they are nonetheless official. It simply
advises a third party that the student had personal possession of the ISSUED TO STUDENT
transcript.
SIGNATURE
DATE
UNDER THE FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT OF 1974, THIS INFORMATION IS RELEASED TO YOU ON THE CONDITION THAT YOU WILL NOT PERMIT ANY OTHER
PARTY TO HAVE ACCESS TO SUCH INFORMATION WITHOUT THE WRITTEN PERMISSION OF THE STUDENT.
============================================================== FOR OFFICE USE ONLY ==============================================================
ACCOUNT CLEAR _____________________ BY _______ | TRANSCRIPT FEE PAID $ __________ BY _______ | DATE PROCESSED _____________________ BY _______
Original Records Yellow Student Revised 11/23/18 Records - CSR
Clear Form
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