Request for Unofficial Transcript (Grades) Form
Please Complete, Print and Fax or Email
First Name* _______________________________________________________ Middle Initial ______
Last Name*
_________________________________________________________________________
Former Name(s) _________________________________________________________________________
Address 1* _________________________________________________________________________
Address 2 _________________________________________________________________________
City* _____________________________________ State* _________ Zip* ________________
Day Phone*
______________ - ____________ - ____________
Last 4 of SSN*
_________________ OR Coyote Tracks ID#: __________________
Date of Birth*
____________ / ____________ / ____________ MM/DD/YYYY
Unofficial Transcript for CMC Grades (Free) 3-5 business days
You may choose to have your grades emailed OR faxed to you:
Fax # (Unofficial Transcript (Grades) Only) OR
Email:
Please note: We are unable send international faxes. If you are at an international location, to receive your
unofficial transcript via email, please provide your email address above.
Signature:
____________________________________________________ Date: ____________________
Mail: Copper Mountain College Fax: 760-830-4157 Questions: 760-830-6133
Base Programs Office Email: unofficialtranscriptrequest@cmccd.edu
Unofficial Transcripts
P.O. Box 1398
Joshua Tree, CA 92252 REV 12/15
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