TranscripT requesT form
please complete this form then print, sign, date and return it with payment to:
milwaukee area Technical college
Transcript Department
700 West state street
milwaukee, Wi 53233-1443
Last Name
First Name
Middle Initial
Former Last Name(s)
Social Security Number or Student ID Number
Date of Birth
Telephone Number
Home Address
City
State
Zip Code
Approximate Dates of Attendance
Mail Transcript to:
Organization _____________________________________________________________________
Attention ________________________________________________________________________
Address _________________________________________________________________________
City _______________________________ State _________ Zip Code _____________________
Prepare Transcript Now
Method of Payment:
Check
Hold Transcript for Grades this Term
Visa
MasterCard
Hold Transcript for Degree Information
Discover
Credit Card Number ______________________ Expiration Date ________________ CVS _____________
please print this form then sign and date it below.
Student Signature
Date
noTe: please provide a handwritten signature and date as required by the family rights and privacy act (ferpa) of 1974.
requests that do not include a signature will not be processed.
MATC is an Affirmative Action/Equal Opportunity Institution and complies with all the requirements of the Americans with Disabilities Act.
2015:03