Lee College Transcript Request Form – Fill Out and Use This PDF

TRANSCRIPT REQUEST FORM

LEE COLLEGE

ADMISSIONS OFFICE

PO BOX 818

BAYTOWN, TX 77522-0818

FAX #: 281-425-6831 OFFICE #: 281-425-6393

Mail or fax request

All obligations to Lee College must be cleared before transcripts may be released. Transcript requests are processed and mailed free of charge within 1 to 2 days. Transcripts sent to student will be designated “Issued to Student”.

I hereby give my consent to release my academic transcript as requested below:

Student’s Signature: _________________________________Date: __________

Please print and complete all information below with dark ink for proper and prompt processing.

** Correct and legible address is the student’s responsibility ** Lee College will not fax transcripts **

Mail transcript to:How many? ______

Name: _______________________________________________________________________

Address: _____________________________________________________________________

_____________________________________________________________________________

City/State/Zip: _________________________________________________________________

My First Name: _________________________MI: ______ Last Name: ____________________

Maiden/Other Name: ___________________________________Date of Birth: ______________

Student’s Lee College ID: ___________________ Social Security #: ______________________

Address: ______________________________________________________________________

City: __________________________State: ________________________Zip Code: __________

Phone number where you can be reached: ___________________________________________

Are you a current student? (circle) Yes No Approximate last year attended: _______________

During peak registration times, transcript requests may have a longer processing time.

Lee College mails official transcript by US Postal Service, please allow for mail delivery time to reach institution.

Revised 10/09