Rev. 9/16
Kekaulike Information & Service Center (KISC)
4303 Diamond Head Road, ‘Ilima 102, Honolulu, HI 96816
Phone: (808) 734-9555 Fax: (808) 734-9896
Got Questions? Email:
Name: ______________________________________________________________________________________________________
Last First Middle Name/Initial
Other Name(s) Used: _______________________________________________________ Date of Birth: _______________________
Address: ____________________________________________________________________________________________________
City: _______________________________________________________ State: _______________ Zip Code: ____________________
UH ID/Username: _________________________________________ Daytime Phone: _____________________________________
Email Address: ____________________________________________ Last Attended KCC: Fall Spring Summer ___________
Signature (Required) ____________________________________________________________________ Date _________________
All transcripts released to the student will be stamped, “ISSUED TO STUDENT. These transcripts bear the KCC seal and are considered official;
however, some institutions/agencies may not accept transcripts that are issued to student. Please check with the receiver before submitting your
request. Under the Family Educational Rights and Privacy Act of 1974, this information is released to you on the condition that you will not permit
any other party to have access to such information without the written permission of the student. Official transcripts of credits earned at other
institutions are not available for distribution by KCC. For admissions purposes, it may not be necessary to send transcripts within the UH System
(check with the UH campus). If sending transcripts to multiple recipients, please fill out individual transcript requests.
Send Transcript To: _________________________________________________________________________________________
Print Clearly.
Student Pick-Up (Must provide valid photo ID)
Third Party Pick-Up. I authorize ____________________________________________ to pick up transcript & deliver it to me. KCC
will not be responsible for loss or damage to the transcript once it is released to the third party (Must provide valid photo ID)
Fax To: __________________________________________________________________________________________
Process This Request: Number of Copies: __________
After grades posted - semester/year ________________________________
After degree conferred - semester/year _____________________________ (Allow for 6-8 weeks after semester ends)
Process Fee and Time:
$5.00 per REGULAR copy - processed within 7 business days Make check payable to: University of Hawaii
$15.00 per RUSH copy - processed within 24 business hours *Fee payment is required before a request is processed.
*Transcripts are sent via USPS only. Process time does not include mail/
delivery time.
For Office Use Only
SOAHOLD: Yes No Fee Charged _____________________ Fee Paid_______________ Processed By/Date________________