Mount Washington College
Registrar’s Office
3 Sundial Ave
Manchester, NH 03103
Tel: 603.296.6428
Fax: 603.314.0096
Student Transcript Request Form
Students must submit all Mount Washington College (formerly known as Hesser College) official and unofficial transcript requests in writing. Official transcript requests will be processed within 5 to 7 business days, provided that the student has met all financial obligations to the College.
Please complete, print, sign, and send this form and any required payments to:
Mount Washington College
Registrar’s Office
3 Sundial Ave
Manchester, NH 03103
Fax: 603.314.0096
Please select one of the following:
❏Mail ASAP |
❏Hold Transcript for Current Term Grades (approx. 2 weeks after end of term) ❏Hold Transcript for Degree Posting |
❏PLEASE UPDATE MY RECORDS TO REFLECT THIS ADDRESS |
LAST NAME(S) WHILE ATTENDING _________________________________________ FIRST NAME __________________________ |
M.I. _______ |
CURRENT LAST NAME (IF DIFFERENT FROM ABOVE) ___________________________________________________ |
SOC. SEC. # _____________________________ STUDENT ID # _______________________ DATE OF BIRTH __________________
CURRENT ADDRESS ___________________________________________________________________________________________
|
STREET |
CITY/STATE |
ZIP CODE |
TELEPHONE # DAY ( |
) _____________________ EVENING ( |
) _____________________ CELL ( |
) ___________________ |
Official transcripts are only released if the student has met all financial obligations to the College.
Official transcripts will not be sent by fax or email.
Your first official transcript request is free (one time only) followed by a $5.00 fee for each additional copy.
Please attach cash/money order, a check payable to Mount Washington College, or include your credit card information below.
❏______ # Official Transcripts: SEE COMPLETE ADDRESSES LISTED BELOW.
(Issued in a sealed envelope, will not be sent via email or fax)
_____________________________________________ |
______________________________________________ |
Name |
(Attn:) |
|
Name |
(Attn:) |
|
______________________________________________ |
______________________________________________ |
Street |
|
|
Street |
|
|
______________________________________________ |
______________________________________________ |
City |
State |
ZIP |
City |
State |
ZIP |
❏______ # Unofficial Transcripts(Free): SEE COMPLETE ADDRESSES LISTED BELOW.
( May be sent via email or fax if indicated in place of mailing address below.) ☐EMAIL |
☐FAX |
|
______________________________________________ |
______________________________________________ |
Name |
(Attn:) |
|
Name |
(Attn:) |
|
______________________________________________ |
______________________________________________ |
Street |
|
|
Street |
|
|
______________________________________________ |
______________________________________________ |
City |
State |
ZIP |
City |
State |
ZIP |
Payment Information: ❏ Cash |
❏ Check/Money Order |
❏ Visa ❏ MasterCard |
❏ Discover |
|
CARD # ____________--_____________--_____________--____________EXPIRATION DATE (M/YY) ___________________TOTAL PAYMENT ENCLOSED$__________
CARDHOLDER’S ADDRESS (IF DIFFREENT FROM ABOVE) _________________________________________________________________________________________
By signing this form, I authorize Mount Washington (formerly known as Hesser) College to release my transcripts to the parties listed above.
*SIGNATURE:DATE:
OFFICE USE ONLY: Registrar’s Office Authorization: ______ free (1st copy only) ______ initials
Number of transcripts requested (@$5 each after 1st free) ______ total fee paid ______ cash/check no./credit/debit
