TRANSCRIPT REQUEST (from PCC)
OFFICE OF ADMISSIONS AND RECORDS - PITT COMMUNITY COLLEGE

Mail to: Registrar's Office Pitt Community College P.O. Drawer 7007 Greenville, NC 27835-7007

- OR -

FAX to: (252) 321-4209

*NOTE: IT TAKES 24 HOURS TO RECEIVE A TRANSCRIPT.
Please fill out the information in the below fields, then print this form and sign it.

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NAME AND ADDRESS IN FULL:

PHONE NUMBER:

SSN:

NUMBER OF COPIES:

PICK UP: (Transcript will be mailed if not picked up within 72 hours)
OR
MAIL TO:

COMPLETE THE FOLLOWING:

A. Currently enrolled? YES NO If no, date last enrolled

B. If you are currently enrolled, do you desire that we hold this request until current semester grades have been recorded? YES NO

C. Name used in school if different from that shown:

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IN ACCORDANCE WITH THE FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT OF 1974, I HEREBY GRANT PERMISSION TO RELEASE A COPY OF MY OFFICIAL TRANSCRIPT.

Signature: ____________________________________________________________________

Date: ___________________________________