MVCC C0-CURRICULAR TRANSCRIPT APPLICATION
Print Name: _____________________________________________________________________________
M Number: _____________________________________________________________________________
Semester: _____________________________________________________________________________
Activity/Honor
Athletic Team
Scholarship/Award
Leadership Experience Position Advisor’s Confirmation
I, the undersigned student, submit this record of my activities for inclusion as part of
my records at Mohawk Valley Community College. I also authorize the College to send
it as part of my records with my academic transcript when so ordered.
_____________________________________________________ _____________________________
Signature Date