Contra Costa College

Transcript Request Form

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Students may receive their first two official transcripts within Contra Costa Community College District free of charge as of 2003; thereafter, it is $5 per transcript. You must request a transcript in writing, by mail, fax or in person. Transcript fees can be paid with a check, money order, Visa or MC. Fax transcript request can only be paid with Visa or MC.

Regular Service: 7-10 working days, first 2 are free of charge; thereafter $5 per transcript. Rush Service: $10 per transcript, next day pick-up/next business day mail.

Express Service: (Only provided with a Rush Service): $10 per transcript, plus additional $15 for overnight mail.

1. Your Name: Last First Middle

OTHER NAMES USED:

2. Address City State Zip

3. Telephone: Area Code -- 4. Birth Date: Month Day Year

5. Social Security Number: -- or Student I.D. Number:

6. Attended CCC from: / to /

Month Year Month Year

7. ACTION:

Regular Processing Rush Request Additional Service, Express Mail ($15

Hold for finals Hold for degree to be posted Hold for grade change (Course) , (Term)
To be sent to UC or CSU only. This service cannot be processed with a Rush Request.

Check One CSU- General Education, CSU- IGETC UC- IGETC

8. MAIL TO:

NAME:

ATTN:

ADDRESS:

CITY: STATE ZIP

9. Number of copies to be sent?

______________________________________ ______________________________________
SIGNATURE DATE

FAXED COPIES MUST HAVE:

MC/VS # Exp Date: Billing Zip Code:

10. Our mailing address is: Contra Costa College

Admission & Records Office

2600 Mission Bell Drive

San Pablo, CA 94806

(510) 235- 7800 ext 4212

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