Seward County Community College

Office of the Registrar w P.O. BOX 1137 w Liberal, Kansas 67905-1137

620.417.1060 (phone) w 620.417.1079 (fax)

TRANSCRIPT REQUEST

Last Name First Name MI Name used while attending SCCC

Mailing Address City State ZIP

SCCC Student ID # or Social Security Number: __________________________________

( ) -

Phone Number

SEND A COPY OF MY SCCC TRANSCRIPT TO: SEND THE COPY

_______________________________________ _____________

Student's Signature Date

TRANSCRIPTS WILL NOT BE SENT WITHOUT THE $3.00 PER TRANSCRIPT FEE.

MAKE CHECKS PAYABLE TO SEWARD COUNTY COMMUNITY COLLEGE

I have included a check made out to SCCC for $3 per transcript ($5 per transcript if the transcript is to be faxed)

Check # ___________________

I have included $3 cash per transcript ($5 cash per transcript if the transcript is to be faxed)

I would like to have the transcript cost charged to my debit/credit card

Type of card: _____________________________

Card #: _______________________________________________

Expiration date: ___________________________

Total amount to be charged:_________________