Student ID#: (if known) ___________________
Last Name: ____________________________________ First Name: _______________________________ Middle Initial: ________
Mailing Address: ______________________________________________________________________________________________
City: __________________________________________________________ State: ____________ Zip Code: ___________________
Any Previous Names: ______________________________________________________________________
Date of Birth: ______________________________ Last 4 Digits of Social Security Number: _____________
Best Telephone Number for Contact: ________________________________________
• Unofficial transcripts are provided free of charge and mailed only to the student as
long as there are no unmet obligations to the College.
• Unofficial transcripts will be mailed within 5 business days to the student address
provided and cannot be emailed or faxed.
• Records prior to 1993 may take up to 10 business days to process prior to mailing.
UNOFFICIAL TRANSCRIPT REQUEST FORM - Office of the Registrar
2240 Iyannough Road │ West Barnstable, MA 02668
774.330.4387│ Fax: 508.375.4084 │ email@example.com │ www.capecod.edu
In accordance with the Family Educational Rights Privacy Act of 1974 (FERPA), I authorize, with my signature,
the release of my student records as well as authorize CCCC to update my Directory Information.
Signature Required: ______________________________________________________ Date: _______________
(Physical signature only; typed signatures are not accepted)
For Office of the Registrar Use Only
Holds: ____________ Copies __________
Completed Date: ________________ Initials: ________