Transcript Request Form - Coastal Carolina University

1 Transcript Request form Office of the registrar Coastal Carolina Box 261954 Conway, SC 29528-6054843-349-2019 843-349-2909 fax PRINT CLEARLY INCOMPLETE INFORMATION MAY RESULT IN PROCESSING Carolina University will issue up to six standard service (paper) transcripts per student per calendar year at no charge. A non-refundable fee of $ per copy must accompany subsequent requests that are made within the same calendar year. Please make your check or money order payable to Coastal Carolina University at the Office of Student Accounts located at 100 East Chanticleer Drive (Baxley Hall). Enhanced service (electronic ordering; electronic delivery; express and first class delivery of paper) official transcripts may be ordered for additional charges please see the Office of the registrar s website for details.

2 NOTE: If you have a hold on your account with the University , it may prevent this Transcript Request from being processed. The submitted Request form will remain valid only for a period of thirty days, in order to allow you to clear the hold that prevents processing. Transcript (s) will not be released to/for anyone except the student, unless appropriately requested in writing by the student. Please present a picture identification when requesting transcripts in person. Name: Last _____ First _____ Middle _____Maiden name (or other names used) _____Student number or Social Security number _____ Date of birth _____This information will be used solely for the purpose of identification and ensuring accuracy in the production of the requested : Home ( _____ ) _____ Cell / Other ( _____ ) _____Email address _____Your current mailing address:Street address _____ (include Bldg.)

3 / Apt. # / Lot #, if applicable) Box _____ City _____ State _____ Zip code _____Processing dates: (check all that apply) n Process now n Hold for grades Date/Term work to be completed _____ n Hold for degree Date/Term work to be completed _____First term attended: Year _____ n Fall n Spring n May n Summer I n Summer II Last term attended: Year _____ n Fall n Spring n May n Summer I n Summer II P If you attended before July 1, 1993, please contact the University of South Carolina at transcripts to: (Use additional sheets of paper if necessary.)Number of transcripts to be sent _____ Number of transcripts to be sent _____Name _____ Name _____Address _____ Address _____ _____ _____ _____ _____Student s signature _____ Date _____FOR OFFICIAL USE ONLYP rocessed by _____Date _____TRRQ _____ registrar Rev.

4 March 2014