Transcript Request Form

Social Security #:	___ ___ ___ - ___ ___ - ___ ___ ___ ____
Name (Last, First, M.I.):	Last: ___________________ First: ____________________ M.I. ____
Maiden or other former names:	______________________________________
Home address:	Address:_________________________________________ City: _________________________________________ St: _________________________________________ Zip: _________________________________________
Daytime Phone (REQUIRED):	___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
_____ Currently enrolled at North Central College _____ Not currently enrolled -- indicate last date of attendance: ____________________
Type and number of copies:	# _____ Undergraduate transcripts # _____ Graduate transcripts
Send transcript(s) to the following address: Name: ___________________________________________ Address: ___________________________________________ City: ___________________________________________ State: ___________________________________________ Zip: ___________________________________________
Student signature (REQUIRED): __________________________________________________ Date of request:____/____/____
If requesting next business day processing:	Method of Payment (circle one): Check DV MC VISA
Credit Card Number:__________________________________________________ Exp.___________________ Vin # (3-digit number on back):_________________

Regular transcript requests are free of charge and typically are processed within 1-2 weeks. For "next business day" processing, please be sure to include the $15.00 fee per copy. If enclosing a check, make it payable to "North Central College."

Mail transcript requests to:
Office of the Registrar
North Central College
30 North Brainard St.
Naperville, IL 60540

Or fax to: 630-637-5257