Office of Enrollment Services, 4000 Lancaster Drive NE, Building 2, Room 200,Salem, OR
Mailing Address: PO Box 14007, Salem, OR 97309-7070
Phone: 503.399.5001 Email: registrar@chemeketa.edu
Chemeketa Community College is an equal opportunity/affirmative action employer and educational institution. To request this publication in an alternative format, please call
503.399.5192.
11/2/2016 s:\registrar\forms\under review-do not use\eme drafts\official transcript request.docx chemeketa.edu
Official Transcript Request
To order your transcript:
1. You can order your transcript through your MyChemeketa account, and it is recommended that you do
so, as it is the fastest and most convenient method. Transcripts ordered online can be sent
electronically for $5, mailed for the same price below, or be ready for pick-up in our office.
a. If you don’t remember your MyChemeketa login, you can do the password reset online, even if
you are no longer a current student. Please call 503-399-7899 for assistance
2. If you must order with this form:
a. Fill out this form completely; payment must be included with your order
b. Submit in person to the Enrollment Center (with picture ID) or mail to Enrollment Services with
payment
c. Mailed requests may take 4-7 business days
d. Pick up requests received before 2 p.m. will be ready for pick up at 3 p.m. the same day
i. To authorize someone to pick up your transcript; print their name in the area provided
below
ii. Picture identification is required when ordering and picking up
iii. Transcripts not picked up within 10 working days will be mailed to your address
Student ID (K#): Date of Birth ______________________
Name: _________________________________________________________________________________
Last, First, Middle
Previous Last Name(s): ___________________________________________________________________
Addr
ess: _______________________________________________________________________________
Street, City, State Zip
Phone Number with Area Code: Cell Phone: ___________________ Email:___________________________
Mail _______Copies Fee per copy: $7.50
Recipient 1 ____________________________________________________________________________
Address ___________________________________City _____________State ______ Zip ___________
Recipient 2 ____________________________________________________________________________
Address ___________________________________City _____________State ______ Zip ___________
Pick Up _______Copies Fee per copy: $7.50
I authorize ______________________________________________ to pick up my transcript on my behalf.
Rush Service For immediate processing of in person orders Additional Fee: $10.00
Special Handling
Hold for current term grades
Hold for posting of degree (only choose this if you will be completing this term)
Student Signature: ______________________________________________ Date:____________________
Office Use Only
I.D. Holds SFAREGS/SHACRSE Transcript fee ______
Rush fee______ Total______
Cash Check Credit/Debit Card Processed by: ______________Date: _______________
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