Highline Community College
Request for Transcripts

Please PRINT this page. 
Fill in clearly and legibly.

3 days processing time.              
Request will be kept on file for 30 days.

Last Name                                          First Name                                                     MI

Student Identification Number
(SID)
if known:                                   
Birth Date:                 
Social Security Number:                                Other names used:                                  
Your social security number is confidential and, under a federal law called the Family Educational Rights & Privacy Act, the college will protect it from unauthorized use and/or disclosure. In compliance with state/federal requirements, disclosure may be authorized for the purposes of state and federal financial aid, Hope/Lifetime Learning tax credits, academic transcripts, assessment or accountability research. The information contained herein is confidential and cannot be released in personally identifiable form without the written consent of the student.
Address:                                                                                         Apt No:                 
City:                                                            State:                       ZIP:                       
Day Telephone:                                         Evening Telephone:                                  
Email Address:                                                                                                           
Please send: # Official transcripts            # Unofficial transcripts        

Check all that apply:

          Send at conclusion of current quarter.               I am a member of PTK.
        Send after degree entered on transcript.   Graduate Year/Qtr:                 
        Attended Highline prior to Winter Quarter 1976
        I will Pick-up my transcript(s).                                                             
                                                                     (Sign here at time of pick-up.)                        Date
        Please Mail my transcript(s) to the address(es) below.
Mail transcripts to: (If different from above. Use blank second page if more than one.
                                                                                                                                                                  
                                                                                                                                                                  
                                                                                                                                                                  
                                                                                                                                                                  
Signature:                                                                                                                                    
                                               Required for ALL requests.

Mail with payment to:
Registration and Records 6-4
Highline Community College
2400 S. 240th Street
Des Moines WA 98198-9800
Include payment for fee.

 

OR

Fax request (if paying with a credit card) to:
Registration and Records    206-870-4855

Circle type of credit card: VISA or Mastercard
Account number:
                                                 
Exp. date:
               Amount to be charged:               

 

Office Use Only. Entered by:                         Date: Fine Type: 
Processed by:                                               Date: Notified:                                                Date:
                             Cleared by:                                           Date: