Office of the Registrar

Transcript Request Form

Name

Current Name:

Previous Name:

Phone Number:

Current Address

Street:

Apt. Number

City, State, Zip Code

Send to Following Address

Name of Institution

Attention

Address

Apt. Number

City, State, Zip Code

Additional Information

Currently Enrolled at Carthage? Yes No

If not, approximate date of last attendance

Number of transcripts requesting

Official Unofficial Send Immediately Hold for Degree/Grades

Please print this form, sign and date it on the lines below, and mail it with payment to:

Carthage College
Office of the Registrar
2001 Alford Park Drive
Kenosha, WI 53140-1994

Signature:___________________________________ Date_____________