Request for Official High School or College Transcript
STUDENT: Please send this form to your high school, or if you have attended college, send one to each college. To be considered
official, transcripts should be sent directly to Palm Beach State
from the issuing institution or be hand-delivered in a
sealed envelope by the issuing institution.
SCHOOL: Florida public high school, college, and/or university transcripts should be sent electronically to Palm Beach State
through the Florida Automated System for Transferring Electronic Records (FASTER).
Please send my official
High School transcript to:
PALM BEACH STATE COLLEGE
ADMISSIONS PROCESSING CENTER, MS 7.5
4200 CONGRESS AVENUE
LAKE WORTH, FL 33461-4796
College transcript to:
PALM BEACH STATE COLLEGE
TRANSCRIPT EVALUATION, MS 7
4200 CONGRESS AVENUE
LAKE WORTH, FL 33461-4796
Last Name: _____________________________ First Name: _______________________ MI: ___
Name used while enrolled at your institution: _______________________________________________
Social Security No.: _________________________ Date of Birth: __________________________
Current Address: ______________________________________________________________________
Street
________________________ ___ ______ Telephone: (____) ____________
City State Zip Area Code
HIGH SCHOOL TRANSCRIPT:
High School Name: _________________________________ Date of Graduation: _______________
COLLEGE TRANSCRIPT:
College Name: ___________________________________ Dates of Attendance: _________________
Graduated? Yes No Date of Graduation: ____________________
Note: Check with the institution to see if there is a fee required for the release of transcripts.
THIS SIGNED FORM AUTHORIZES THE RELEASE OF A COPY OF MY TRANSCRIPT TO PALM BEACH STATE
COLLEGE.
_________________________________________ ___________________________________
Student’s Signature (Required) Date
6/30/16 Transcript to Palm Beach State
Print Form
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