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OFFICE OF THE REGISTRAR (White Mountains Community College)

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OFFICE OF THE REGISTRAR
White Mountains Community College
2020 Riverside Drive
Berlin, NH 03570
Phone Number: 603-342-3050
Fax Number: 603-752-6335
Email: wmcctranscripts@ccsnh.edu
AUTHORIZATION TO RELEASE RECORDS
Transcript Request Form
I authorize White Mountains Community College to release, send, or open to
inspection, transcripts maintained at the College.
Print Student’s Full Name
000-00-
Last Four Digits of SS #
Mailing Address
Date of Birth
City State
Zip Code
Primary Phone Number
________________________
Email Address
List other names used on school records (if applicable):
List academic year(s) in which credits were earned
I request this information be forwarded to:
College/Other:
Attention:
Mailing Address:
City/State/Zip:
ALL TRANSCRIPTS ARE COMPLIMENTARY
For Office Use Only: Date Record Released: _____ Student ID: ____________
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OFFICE OF THE REGISTRAR (White Mountains Community College)

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Completed 26 July 2020

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