Fillable Transcript Request Form (Northern Maine Community College)

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Transcript Request Form (Northern Maine Community College)

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Transcript Request Form
A hand-wrien signature is required for the release of records. Records are not released by email. Records are not released if there is an out-
standing nancial obligaon to NMCC. NMCC is not responsible for bad recipient informaon or technology failures, such as bad fax numbers or
wrong recipient address.
OFFICIAL TRANSCRIPTS ARE NOT ISSUED TO STUDENTS
Student
Name:____________________________________________
Previous
Name:____________________________________________
Are you a previous graduate of NMCC? ___________(Year)
Birth Date: ________________________________________
SSN:______________________________________________
Student’s Contact Informaon (Complete mailing address)
____________________________________________________
____________________________________________________
____________________________________________________
Phone (Cell)_________________________________________
Phone (Home)_______________________________________
E-Mail______________________________________________
I am requesng:
_________Ocial transcripts _________Unocial transcripts
Send Immediately Hold for semester grades
Hold for Degree Conferred
The Federal Educaonal Rights & Privacy Act of 1974 requires that all tran-
script requests must be in wring, signed and dated by the person to whom the
record belongs.
STANDARD (FREE )processed in 2- 5 business days.
(US Mail)
FAXED$10.00 (a faxed copy is NOT ocial)
EXPEDITED Processing *(US Mail) $25 per transcript
Processed within one working day (of receiving)
Overnight Delivery * (Fed-Ex) $100 processed within one
working day. Includes expedited processing fee.
*Payment required before processing, (if due)
_______________________________________________________________
Card Number Expiraon Date CVV (on signature line)
Send to: Number of copies: _______________
___________________________________________________
____________________________________________________
___________________________________________________
Please sign below: (SIGNATURE REQUIRED)
___________________________________________________
For those enrolled in the Liberal Studies-AA in Fall 2017 or later:
I have fullled the Maine Community College System/University of
Maine System Transfer-Out Block (34-35 credits of specic general
Educaon coursework) and wish to have my transcript reviewed and
cered, if appropriate.
** This opon is not eligible for Expedited Processing.**
OFFICE USE ONLY: Block transfer Cercaon :
Meets Block
Does not Meet Block Reviewed by: __________________________________________Date:______________________
33 Edgemont Drive, Presque Isle, ME 04769 Tel: 207-768-2787 Fax: 207-760-1106 Email: transcripts@nmcc.edu
Request received: ______________________________ Student ID#:____________________________________________
Holds: ________________________________________ Address Correct/Corrected:_______________________________
Recorded:_____________________________________ Payment Received:______________________________________
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Transcript Request Form (Northern Maine Community College)

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Completed 26 July 2020

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