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Processed by _______________ Date _____________________
OFFICIAL TRANSCRIPT REQUEST
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COMPLETE REQUEST NOW
HOLD REQUEST UNTIL CURRENT COURSE GRADES ARE POSTED
CHOOSE MAILING OR PICK UP OPTION AND INDICATE QUANTITY:
MAIL _____ COPIES OF MY TRANSCRIPT TO:
Individual/Organization:
Department:
Street Address: ___________________________________________________________________________
City: ______________________________________ State: _______________ Zip: ____________
MAIL ME _______ COPIES OF MY TRANSCRIPT
I WILL PICK UP _______ COPIES OF MY TRANSCRIPT (Photo ID is required for pick up.)
I GIVE PERMISSION FOR THE FOLLOWING INDIVIDUAL TO PICK UP A TRANSCRIPT ON MY BEHALF:
Individual’s Full Name _________________________________________________________________________________
Photo ID is required for pick up. No transcript(s) are released to other individuals without this information and the student’s signature below.
STUDENT SIGNATURE ______________________________________________________ DATE _____________________
Unless sent from an official Rockingham Community College email account, this form must have a handwritten signature.
In Person:
Mail:
E-mail:
Fax:
Questions?
Bishopric Lifelong Learning Center (BLLC)
Trina Jones, PO Box 38, Wentworth NC 27375-0038
jonest6822@rockinghamcc.edu
(336) 634-3023
Call (336) 342-4261, ext. 2146
Name: ______________________________________________________
Street Address: _______________________________________________
City: _________________________ State: ___________ Zip: __________
Day Phone: __________________________________________________
Any Other Name(s) ____________________________________________
Date: ________________________________________
ID# or last 4 of SSN ____________________________
Date of Birth __________________________________
I am currently enrolled.
I am not currently enrolled.
Year Last Enrolled at RCC: ____________________
return form:
Adult High School transcripts are free of charge.
Rev 10/1/18
Transcripts must remain sealed to be official.
Requests for multiple copies are sealed separately and housed in one envelope; the outer envelope can be opened.
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