Transcript Request Form

Below is a transcript request form which you must complete in order to receive a transcript of your grades from EWC. Federal law requires that transcripts be released only by signature, so this form will have to be printed, signed by you, and mailed to EWC. There is no fee for transcripts.

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Please enter your full legal name used during attendance:


Personal Information

 First Name
 Middle Name
 Last Name
Date of Birth: M-D-Y
 Social Security #


Current Telephone #
(###) ###-####


Current Mailing Address


City, State, ZIP


City


State


ZIP

I hereby request and authorize officials at Eastern Wyoming College to release the following information concerning myself:

 

Please indicate the number of copies of each type of record:

Official College Transcript
Unofficial College Transcript
Placement Test Results
Other Records:

 

Please send:

Immediately
After New Grades are Posted
Current Grades Immediately & After New Grades are Posted
 

For the purpose of:

College Admissions
Job Application
Other:

 

Please release this information to:

Name
(College, Institution,
Employer, or Individual)
Mailing Address
City, State, ZIP

City
State
ZIP

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