Official Transcript Request Form

One Riverside Drive
East Hartford, CT 06118
         
         
Please note:  There is a $10.00 charge per official transcript.  Please allow up to 10 working days for processing and mailing, except at the beginning and end of a semester, when up to 3 weeks may be required. We accept the following credit cards:   Discover, MasterCard, Visa, American Express and Diners Club.

Transcripts will not be processed for anyone with an outstanding balance due to the college.  If you have a balance your request will remain pending and you will be contacted by our office.
 
First Name:          Middle Initial:      Last Name: 
Previous Name (if applicable): Date of Birth:
Student ID:
Credit Card Number: Expiration Date: CVV2 # (3 digits on the back of the card)
Address:  
City:  State:  Zip Code:
Home Phone:  Work Phone:  Cell Phone: 

Is the above address new to our records?   Yes   No

Electronic Signature: 

Number of copies to be sent to addressee below:  

Name and address of recipient:  (If to yourself, write "Self"):
 

 
Name and address of recipient:  (If to yourself, write "Self"):  

 

 

Name and address of recipient:  (If to yourself, write "Self"):  

 

   
  Office Use Only
Accounting Approval  __________________
Registrar  _______________________