Transcript Request Form
(Not to be used for IGETC/CSU GE Certification)
List number of copies in box provided
NUMBER OF COPIES: OFFICIAL NUMBER OF COPIES: UNOFFICIAL
Today’s date: _________________ Daytime phone number: ____________________________
Name (Print Clearly): _______________________________________________________________
Last Name First Name
Other Last Name(s): ____________________________Student ID/SSN: _____________________
Email Address: __________________________@insite.4cd.edu (All communications will go through your InSite email)
Date of Birth: ____________________ Approximate Dates of Attendance: _____________________
Send transcript to: _________________________________________________________________
Office/Attn: _______________________________________________________________________
Address: _________________________________________________________________________
City/State/Zip: _____________________________________________________________________
SIGNATURE __________________________________________________________
The first two official transcripts within the Contra Costa Community College District are free. After this, official
transcripts are $5.00 each.
Unofficial transcripts are available for a $1.00 fee (students can print a free unofficial transcript from WebAdvisor)
Rush Processing is available at $10.00 additional per transcript in addition to the regular $5 processing fee (if
applicable).
Express Processing is only available in person for $25.00 in addition to the regular $5 processing fee (if applicable).
IGETC or CSU GE certification cannot be requested on this form (see separate form).
Transcripts may be requested directly through InSite-WebAdvisor (call us to reactivate your account), in person or by mail; email and
fax requests are not allowed. Transcripts processed through the LMC Admissions & Records Office will reflect LMC courses only. LMC
uses regular postal service only. Multiple requests will be treated as separate requests. Check WebAdvisor prior to requesting your
transcripts to ensure grades and/or degrees have been posted. We will not hold transcript requests for grades or degrees to be
posted.
Regular Processing will take up to 7-10 working days. Pick up service is not allowed for regular processing.
Rush Processing received by 3:00 pm Monday through Thursday and 12:00 noon on Friday are processed the following
business day by 10:00 am. Rush transcripts may be mailed or picked up by the student (Photo ID required). If the student has
not picked up the transcript in one month, it will be mailed to the address provided.
Express Processing must be requested in person
at the main campus (Pittsburg) and is produced within one hour
(Photo ID required).
Credit Card Number________________________________________________________________
Expiration Date____________Billing Zip Code_________
Revised 07-26-11
_____ Rush Request – Pick up
(Please provide student’s current address
in space above.)
_____ Rush Request – Mail
_____ Express Processing (in person only)
TO MAIL THIS FORM, PLEASE SEND TO:
Los Medanos College
Admissions Office/Transcript Request
2700 East Leland Road
Pittsburg, CA 94565
This form can be mailed with a check made out to LMC or
MasterCard, VISA, Discover - Questions (925) 439-2181 x7500
Fax Requests are Not Accepted
