Name:
Last First MI Other Name Used
Address:
Street City State/Zip Date of Birth
SEND TRANSCRIPT(S) TO: (Print full name and address clearly)
Number of Copies:
Number of Copies
I give permission to update my address and phone number as listed above on my college record.
For expanded delivery options and services, order your Transcripts Online!
Go to www.msjc.edu/transcripts for more information on Electronic Delivery and FedEx options.
The first two transcripts and/or enrollment verifications are free of charge upon written request only.
Requests submitted online will have all charges applied.
*All outstanding financial obligations must be cleared before transcript(s) can be processed.
**Only Mt. San Jacinto College transcript(s) will be issued. Copies of other schools’ transcript are not included.
Mail Rush Mail Pick-Up Rush Pick-Up
► up to 10 business days to process ►1-2 business days to process ►up to 7 business days to process ►1-2 business days to process
Transcript Fee: $5.00 per transcript (Applies to all requests types)
Instant Service Fee: $8.00 per transcript (Additional charge applied to Rush Mail or Rush Pick-up ONLY)
I request a transcript(s) (will not include grades for current term.)
Hold transcript request until final grades are posted. Term/Year
Hold my transcript until degree or certificate is posted. Term/Year
I request GENERAL EDUCATION certification: CSU OR IGETC Transferring to
Have you attended any other college(s)? (Transcript must be on file.)
Have you taken a foreign language in high school? (Transcript must be on file.)
Note: If you owe fees and would like to pay with a credit card, please include credit card information below.
We accept MasterCard, Visa, and Discover. We will also accept checks or money orders payable to MSJC.
Credit Card Type Credit Card Number Card Expiration Date Card Security Code (CSC)
Signature: Date:
Student signature required for all requests. If not signed, request will be returned.
1499 N. State Street
San Jacinto, CA 92583
Phone: (951) 487-3215
Fax: (951) 654-6738
28237 La Piedra Rd.
Menifee, CA 92584
Phone: (951) 639-5215
Fax: (951) 672-6548
Temecula Education Complex
27447 Enterprise Circle West
Temecula, CA 92590
Phone:(951) 506-6752
Fax: (951) 693-5309
3144 W. Westward Ave.
Banning, CA 92220
Phone:(951) 922-1327
Fax: (951) 922-1408
Dept:
Street:
City/State/Zip:
Student ID#
Dates of Attendance
Phone #
Office Use Only
Received by No Charge ( ) Amount Paid ( )
Date Sent: Check ( ) Cash ( ) Charge ( ) Owes ( )
ES878 11/17 White – Admissions Yellow – Student
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