TRANSCRIPT REQUEST FORM
OFFICE OF THE REGISTRAR – 221 S. QUARTERLINE ROAD, MUSKEGON, MI 49442
EMAIL: officeoftheregistrar@muskegoncc.edu
PHONE: 231-777-0310
FAX: 231-777-0209
Fill out form completely. Transcripts released to students in sealed envelope may not be accepted as official by the receiving institution. Note: Transcripts will not be issued
to any student whose financial obligation to the College has not been satisfied. Transcripts requested for pick-up will be ready within 2 business days.
*Transcript Requests are normally processed within 3 business days but may require more time to process prior to or at the end of the semester.
Date of Request
Student Name: Last
Last date attended (if known)
First
Date of Birth (mm/dd/yyyy)
Middle
Current Address:



Student Number or Social
Security Number
City
Send Transcript Immediately
Hold for Current Grades in ____________________ date semester ends
Hold for Grade change in course name here: ____________________
Mail to Recipient Name:
Telephone Number
Previous Name Used
State
Zip
Number of Transcripts
Requested
 I will pick-up my Transcript (bring photo identification with you)
 Hold until Degree in___________________ is record at end of semester
 Hold until MACRAO is recorded on______________ date semester ends
Address:
City:
State:
Student Signature : ____________________________________________________
Required to release Transcript
Zip:
Date _____________
Required (mm/dd/yyyy)
Note: The Family Right and Privacy Act of 1974 prohibit the release of student records to a third party without the students written consent.
Processed By and Date: ____________________________________________
 Unfilled Financial Obligation –Transcript not sent