IMPORTANT!  YOU MUST COMPLETE ALL SECTIONS FOR THIS REQUEST TO BE PROCESSED
 1. Transcript of: _______________________________________________________________
                               Last Name                                                    First                                      MI
    2. For work taken at:
 
LACC
 
Military Base

 3. STUDENT IDENTIFICATION NUMBER

     OR  SOCIAL SECURITY NUMBER:

     
-
   

-
       
 4. BIRTH DATE                       

  __________________________________
    Month                   Day                    Year
 5. PLACE OF BIRTH

  ________________________________________________
                          City                                           State  
 6. INDICATE ANY OTHER NAME USED AT LACC:

  _______________________________________________________________________
 8. Check below if you wish transcript HELD:
 
 For FINAL GRADES of
 
 Fall
 
Summer
 
 Spring
 
 Winter
  Year:  _____________
 
 Until INCOMPLETE or
 GRADE CHANGE is
 completed
  
 Until DEGREE is recorded

                            (Approximately 8 weeks after term ends)                                    

 7. LIST THE 1st SEMESTER & YEAR ATTENDED AND
    THE LAST SEMESTER & YEAR ATTENDED AT LACC:

      ____________________________________________
            1st SEMESTER                                     YEAR

      ____________________________________________
            LAST SEMESTER                                 YEAR
 
         OFFICE USE ONLY
 
 Certification Requested

Number of Copies
 
9. Mail Transcripts to: _________________________________________________________________________________________________
                                          School, Institution, etc.  (Complete Part Two below)
10. Date: ____________________    11. Student Signature: __________________________________________________________________

Part Two

OFFICIAL TRANSCRIPTS OF CREDITS EARNED AT OTHER INSTITUTIONS ARE NOT
AVAILABLE FOR REDISTRIBUTION BY LOS ANGELES CITY COLLEGE

STUDENT IS RESPONSIBLE FOR CORRECT ADDRESS

 

  
STUDENT:        
1.This Transcript Request can
be processed only if all of the requested information is provided. 		  ____________________________________________________________________________________
     Name of Institution or School where Transcript is to be sent

  ____________________________________________________________________________________
     Address pt 1
2. Complete one Transcript
Form for each address to
which you are sending copies.		   ____________________________________________________________________________________
     Address pt 2

  ____________________________________________________________________________________
     City                                                                   State                                                                 Zip   
3. For more than one copy to the
SAME address, complete only one
form, and indicate in the box to the right the number of copies to be
sent to that address.
 

Los Angeles City College
TRANSCRIPT REQUEST
Admissions Office

COMPLETE SECTIONS A, B, AND C BELOW

OFFICE USE ONLY
Dear Student:
  Your request is being returned for a fee
  payment of $______.  Please return your
  check or money order along with this
  ENTIRE form to the address below.

  ___________  Transcript(s) sent
__________________________________

      TRANSCRIPT UNIT
      LOS ANGELES CITY COLLEGE
      855 N. VERMONT AVENUE
      LOS ANGELES, CA 90029
 
 A. Transcript to be sent to:

 
 B. Day Phone: (       )            -                          Evening:  (       )          -     
 
 C. Print your mailing address here:

  ____________________________________________________________________________
    Name:   First                                                                       Last

  ____________________________________________________________________________
    Address

   ____________________________________________________________________________
     City                                                               State                                             Zip
 

Transcripts are PROCESSED IN 5-10 DAYS. The first two regular transcripts ever requested are free.

EACH ADDITIONAL, regular transcript is $3.00.

Special emergency transcript requests are processed within 24 hours.

Each and every emergency transcript printed is $10.00

PAYMENT MUST ACCOMPANY REQUEST.
 
                     Mail Completed Form to:
  Admissions Office, Transcript Unit
  Los Angeles City College
  855 N. Vermont Avenue
  Los Angeles, CA  90029