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1601 39th Ave. S.E.
Puyallup, WA 98374-2222
(253) 840-8400
TRANSCRIPT REQUEST FORM
Circle last site attended:
Puyallup Fort Lewis McChord
(Fill out separate request for each address)
Fort Steilacoom
Other Attended from to
/ /
LAST NAME FIRST INITIAL STUDENT IDENTIFICATIONNO.
Please check items that apply:
ADDRESS NAME ATTENDED UNDER
CITY STATE
TELEPHONE
EMAIL ADDRESS
Please send transcripts to: (Please print)
ZIP
BIRTHDATE (M/D/Y)
# of Unofficial Transcripts
# of Official Transcripts
Name
Address
CITY STATE ZIP
Student’s signature
(Will not be processed without your signature.)
Date
❏ Send a.s.a.p.
❏ Pickup transcript
❏ Send after current quarter grades posted:
(circle one) Summer Fall Winter Spring
❏ Hold for grade change:
Course & No.
_________________________________
❏ Have earned/applied for degree at Pierce?
Mo/YrGraduate(d)
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Allow 2 to 3 working days for processing transcripts. Transcripts
not released if outstanding financial obligation to the college exists.
PAYMENT REQUIRED. For Official Transcripts to pickup or for Official Transcripts mailed directly to the student,
there is a $5 non-refundable fee
per official transcript.The fee must be paid before the transcript is prepared. Pay at the Cashier's Office. There is no fee for transcripts send directly to
other institutions or agencies.
1906 TM
OFFICE USE ONLY
Date payment received: Payment type: By: Date:
