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FORMER HIGH SCHOOL OR COLLEGE TRANSCRIPT REQUEST …

Revised June 2013 FORMER high SCHOOL OR COLLEGE TRANSCRIPT REQUEST FORM Please send my official academic TRANSCRIPT , including any placement test scores to: ST. JOHNS RIVER STATE COLLEGE ATTN: ADMISSIONS OFFICE 5001 ST. JOHNS AVENUE PALATKA, FLORIDA 32177 COLLEGES AND UNIVERSITIES: PLEASE PROVIDE COURSE DESCRIPTIONS FOR ALL COURSES ON STUDENT S ACADEMIC TRANSCRIPT . If there is any charge for this TRANSCRIPT , or if my TRANSCRIPT cannot be forwarded immediately, please notify me at the address and phone number listed below: STUDENT S NAME: _____ SOCIAL SECURITY NUMBER:_____ DATE OF BIRTH:_____ STREET ADDRESS:_____ CITY, STATE ZIP CODE:_____ DAYTIME TELEPHONE NUMBER:_____ DATES OF ATTENDANCE:_____ _____ STUDENT S SIGNATURE DATE NON-DISCRIMINATION STATEMENT St.

Revised June 2013 FORMER HIGH SCHOOL OR COLLEGE TRANSCRIPT REQUEST FORM Please send my official academic transcript, including any placement test scores to:

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Transcription of FORMER HIGH SCHOOL OR COLLEGE TRANSCRIPT REQUEST …

1 Revised June 2013 FORMER high SCHOOL OR COLLEGE TRANSCRIPT REQUEST FORM Please send my official academic TRANSCRIPT , including any placement test scores to: ST. JOHNS RIVER STATE COLLEGE ATTN: ADMISSIONS OFFICE 5001 ST. JOHNS AVENUE PALATKA, FLORIDA 32177 COLLEGES AND UNIVERSITIES: PLEASE PROVIDE COURSE DESCRIPTIONS FOR ALL COURSES ON STUDENT S ACADEMIC TRANSCRIPT . If there is any charge for this TRANSCRIPT , or if my TRANSCRIPT cannot be forwarded immediately, please notify me at the address and phone number listed below: STUDENT S NAME: _____ SOCIAL SECURITY NUMBER:_____ DATE OF BIRTH:_____ STREET ADDRESS:_____ CITY, STATE ZIP CODE:_____ DAYTIME TELEPHONE NUMBER:_____ DATES OF ATTENDANCE:_____ _____ STUDENT S SIGNATURE DATE NON-DISCRIMINATION STATEMENT St.

2 Johns River State COLLEGE does not discriminate against any employee, prospective employee, student, or student applicant in admission or access to, or treatment or employment in, its programs and activities on the basis of race, ethnicity, color, national origin, marital status, religion, age, gender, genetic information or disability. Questions regarding this statement or compliance with laws relating to non-discrimination may be directed to the Equity Officer, St. Johns River State COLLEGE , 5001 St. Johns Avenue, Palatka, Florida, 32177; 386-312-4070.

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