STUDENT TRANSCRIPT REQUEST

P.O. Box 610 Holbrook, AZ 86025 (928) 524-7459 Fax: (928) 524-7461

n Email: transcripts@npc.edu
TRANSCRIPT FEES: Transcripts are $10 each; $15 each for pickup at R&R office in Holbrook; $20 each + USPS overnight
fee ($19.99 Subject to change) for overnight delivery. No transcript of a student's record will be released until all financial
obligations to the college have been satisfied. Please allow 5 business days for processing.

One official transcript contains your entire class history at NPC.

NPC Student ID # and/or Date of Birth

Today's Date

Student Name: ________________________________________________________________________________________________________________________

Last

First

Middle Maiden

Student's Current Mailing Address:____________________________________________________________________________________________________

AZ ZIP:_____________________
City: __________________________________________________________ State: _______
joe.student@mail.npc.edu
Best way to contact you between 8 a.m. and 4 p.m.: Phone:____________________________ Email____________________________
NOTATION NEEDED ON TRANSCRIPT:

WHEN SHOULD TRANSCRIPT(S) BE PROCESSED?

____ Send Now
____ Hold until degree is posted

AGEC

in Progress

Completed

Hold for current semester grades

Arizona General Education Curriculum - A block of 35 credits of lower division

general education courses that fulfill requirements at Arizona's state universities
and community colleges.

____ Hold for correction. Type: ___________________________________________________

Language Proficiency 2 Semesters 4 Semesters

For each address, enter the number of transcripts to be processed under each category
Mail transcript(s) to: (You MUST Provide Full Name and Mailing Address)

Second destination
Replace this text with the
Name and Complete Mailing
Regular
Address to which the
Mail
transcript should be mailed.
Use boxes to the right if
additional transcripts go to
Overnight
other destinations.

PAYMENT METHOD
VISA

MasterCard

Third destination

Regular
Mail

Overnight

Make checks or Money Orders

payable to Northland Pioneer College

Discover

Overnight

Transcript Fee

0.00
$___________________

Overnight Fee

0.00
$___________________

Card #____________________________________________________ Exp. Date:___________________

Cash

DO NOT MAIL CASHMoney

Order Check Check #___________________

0.00

Total $___________________

Fill out this form, then print out a copy. Sign and date, then either mail, FAX, or scan and email to
the Records & Registration office (Submission information above) or bring to your local NPC office.

Student Signature Authorizing Release REQUIRED

R&R Use:
Notes:

Regular
Mail

Print

Date
Transcript(s) Mailed: ____________________

PUBLIC NOTICE OF NONDISCRIMINATION: Northland Pioneer College does not discriminate on the basis of race, color, national origin, veteran status, religion, marital status, gender, age or disability in admission or access to, or treatment or employment in its educational programs or activities. District grievance procedures will be followed for compliance with Title IX and Section 504 requirements. The Affirmative Action Compliance Officer is the Director of Human Resources, 2251 E. Navajo Blvd.,
Holbrook, Arizona 86025, (800) 266-7845. The Section 504 Compliance Officer is the Coordinator of Disability Resource and Access, 1001 W. Deuce of Clubs, Show Low, Arizona 85901, (800) 266-7845. The lack of English language skills will not be a
barrier to admission and participation in vocational education programs.
MPR-EcR 10/22/14 /Marketing/Forms/Rec & Reg/Transcript Request/StudentTransRequest-webform14v3