Transcript Request

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FENNELLCAMPUS

BRANTFORDCAMPUS
STARRTCAMPUS
IAHSCAMPUS

TRANSCRIPTREQUESTFORM

THESQUARESTUDENTSERVICES
STUDENTSERVICES
STUDENTSERVICES
STUDENTSERVICES

135 Fennell Ave W., Hamilton, ON L8N 3T2

Tel.: 905-575-2000

411 Elgin St., Brantford, ON N3T5V2

Tel.: 519-758-6014

481 Barton St., Stoney Creek, ON L8E 2L7

Tel.: 905-575-1212 ext. 5021

1400 Main St W., Hamilton, ON L8S1C7

Tel.: 905-540-4247

Fax:
9055752109

SECTIONAPersonalInformation
NAME:[FIRST,MIDDLE,LAST]

STUDENT#:

PREVIOUSNAME(IFAPPLICABLE):

STREETADDRESS:CITY:PROVINCE:

POSTALCODE:

DATEOFBIRTH:

EMAILADDRESS:

HOMEPHONE#:

ALTERNATEPHONE#:

SECTIONBStudentRecordandGraduationInformation
Program/Course:

Campus

YearsAttended:

Graduated:NoYesYearofgraduation________

From________To________
Program/Course:

Campus

YearsAttended:
From________To________

Program/Course:

Campus

YearsAttended:
From________To________

Graduated:NoYesYearofgraduation________

Graduated:NoYesYearofgraduation________

PleaseAllow5to7BusinessDaysforProcessing

SECTIONCTranscriptsRequired

NumberofTranscriptsRequired:________
SendNowSendafterFinalGradesrecordedSendafterConvocation*

*TranscriptswillnotstateDiploma/Certificate
Awardeduntilaftertheconvocationceremony.

Printforpickupat__________________Campus
Faxto:_________________________
(name/organization)
_________________________
(faxnumberfaxedcopiesarenotofficial)

1.Thereisnofeeforprocessingtranscriptrequests.
2.Transcriptrequestsareonlyacceptedinperson,bymail,orbyfax,
asyoursignatureisrequired.
3.Youareresponsiblefortheaccuracyofallinformationonthisform.
4.Itisyourresponsibilitytoreviewyouracademicrecordforaccuracy.
5.Transcriptswillonlybereleasedforpickupuponpresentationofappropriate
IDorasignedletterofpermission.
6.Transcriptswillnotbereleasedforstudentswhohaveoutstandingliabilities
withtheCollege.

Mailto:HomeAddress
Institution(s)/Organization(s)listedbelow:
(forcolleges/universitieswithinOntario,includeyourreference#;forinstitutionsoutsideOntario,includemailingaddress)

*Pleaseincludeadditionalsheetsifinsufficientspace*

SIGNATURE:

DATE:

FOR OFFICE USE ONLY


DATEPROCESSED:_____________________PROCESSEDBY:____________MailedFaxedReadyforpickupat_____________
Updated:October2011(initials)

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