Office Use Only

FICE CODE:

Spartanburg Methodist College

TRANSCRIPT REQUEST FORM

You may type your information on this form, print, sign the form and mail it to Office of the Registrar,
Spartanburg Methodist College, 1000 Powell Mill Rd., Spartanburg, SC 29301. Please complete
one form per request. A $5.00 fee is required for each request.

Use the [Tab] key to get to the next line; [Shift] [Tab] for previous line
STUDENT NAME
STREET ADDRESS

APT. NO.

CITY/STATE/ZIP

DAYTIME PHONE NO. S.S. NO.

CHECK WHERE APPROPRIATE

Traditional Student Evening Student Currently Enrolled
Not Currently Enrolled Joint Enrollment Student (w / HS)
Dates Attended
Send Transcript Now Hold Until End of Term

SEND TO
NAME OF COLLEGE, UNIVERSITY, EMPLOYER, STUDENT, ETC.

NAME/DEPARTMENT
ADDRESS

Via Fax Fax No.: Via US Mail Hand Delivered

My signature grants special permission to Spartanburg Methodist College to secure academic
performance information from the institution listed above without additional authorization from
me. I understand this information will be used for institutional research and study of an
impersonal nature only.

Signature: ______________________________________ Date: ___________________

Transcript Release Policy: A transcript will only be released with the written consent of the student. No
transcript will be released for a student whose financial obligation to the college has not been satisfied.

Office Use Only: Date Processed: __________________________

Official Transcript: ______________________ Payment Amount: _________________________
Student Copy: ______________________ Cash:_____ CC:_____ MO:_____