Today’s Date ____________________________________________________ Check one: Pick Up Mail Now Mail at end of Semester
Name _____________________________________________________________________________ Social Security No. _________________________________________
Address __________________________________________________________________________ Date of Birth ______________________________________________
City/State/Zip _____________________________________________________________________ Telephone _________________________________________________
Presently enrolled at Mitchell? Yes No If no, last date you attended _____________________________________________
PLEASE FORWARD A COPY OF MY TRANSCRIPT TO: Check all that apply:
______________________________________________________________________________________ Adult High School Diploma
______________________________________________________________________________________ Continuing Education
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Signature
MCC-144 An Equal Opportunity College / Affirmative Action Employer Rev. 08/16
Continuing Education Division
Transcript Request Card
Transcripts are not released without the written
permission of the student. Allow at least 48 hours for
transcripts to be prepared, and up to 5 days at the
end of a semester.
Fax or mail completed document to:
Computer Operator, Continuing Education Center
Mitchell Community College
701 West Front Street, Statesville, NC 28677-5644
Fax (704) 878-4271
