TO: Jim Hamberg, Director, Records and Registration
FROM:
Dr. Thomas J. Hendricks, Instructor, Communication
Skills
Department
The following student needs his/her grade in my class transferred to
another institution. The student has been directed to complete a transcript
request form from the Records and Registration Office, 101 Madison Hall.
SOCIAL
SECURITY OR STUDENT ID NUMBER ____________________
Institution
to which grade needs to be sent: ____________________________
Name
of contact person at other institution: ___________________________
Fax
number of contact person at other institution: ______________________
COURSE
NAME AND NUMBER ____________________________________
QUARTER
AND YEAR ____________________________________________
FINAL
GRADE EARNED __________________________________________
Instructor
Signature (required) ______________________________________
This
form will not be accepted without the instructor’s signature.
Partial grades [in progress] cannot be transferred.
STUDENTS
MAY NOT DELIVER THIS FORM. PLEASE
RETURN VIA INTEROFFICE MAIL TO THE RECORDS AND REGISTRATION OFFICE, 101 MADISON
HALL, OR HAND DELIVER (BY A COLLEGE EMPLOYEE ONLY) TO THIS OFFICE.