Official College Transcript Request
1. Complete a separate transcript request for each address to which a transcript is to be sent. There is a $5 charge for each
transcript. Incomplete forms or missing payments will not be processed.
2. By mail: Complete the transcript request form below, print, sign, include payment of check or money order, and mail to
Records and Registration Office, 58900 Cherry Grove Road, Dowagiac, MI 49047
3. In person: Payment must be made at the Business Office at the Dowagiac campus or Niles Area Campus. Complete the transcript
request form and submit with receipt to Records Office, Room 1106 Briegel Building, Dowagiac Campus or Main Office,
Niles Area Campus.
Student ID or Social Security # _______________________________________ Birthdate ____________________________
Student’s Current Name __________________________________________________________________________________
First M.I. Last
Former Last Names (if any) ________________________________________________________________________
Students Street Address _________________________________________________________________________
City _________________________________State ______________________ Zip Code _______________________
Telephone ________________________________ Email Address ________________________________________
Approximate Dates of Attendance _________________________________________________________________
Student Signature _______________________________________________ Date ___________________________
Delivery Instructions (Please Check One)
Pick Up Mail Now Mail after Posting Grades Mail after Posting Degree
Express Printing - $20 fee (Dowagiac campus only)
Number of Copies _____________________ $5.00 per copy
Mail Transcript to
click to sign
click to edit