Release of Transcript
& Other Records
LAST 4 Digits only! of your SS#:
Date:
Name:
Last:
First:
Middle:
Maiden/Previous
Address:
Street
City
State
Zip
Phone:
Home
Contact or Work
Email address:
Purpose of request?
Did you attend before the Fall of 1990?
yes
no
If Yes, indicate the campus attended
Please Mail My Transcript to:
Name:
(School, Institution or Individual)
Address:
Release of Other Records
Class Schedule
Verification of Enrollment
Other - Please List
Please Note:
As stated in the Ivy Tech College Catalog we cannot release the official documents obtained from High schools or other institutions of higher education.