ACD_002
Form1

Normal processing time is 5 working days. Please allow a longer time to process requests made at the beginning and end of a semester

Request for Transcripts


Heartland Christian College
Registrar’s Office
500 New Creation Rd., Newark, MO, 63458
Fax: (660)284-4098, Phone (660)284-4800

Please provide all of the following information, print this form, sign it, and mail or fax it to the Registrar’s Office.

Date of request:

First Name: Last Name:

All Other Names You Have Used:

Current Mailing Address:

Phone:    E-mail:

Approx. Dates of Attendance:   Date of Grad.
mth/yr

Please send copies of my transcript(s) to the following address:
A complete address must be provided. Fill out a separate form for each address.

Signature: _________________________________________   Date:_______________
(Request will not be processed unless signature is included.)Confirmation that your transcript has been sent will be mailed from registrar@heartlandcollege.org to your e-mail account.


     Please also fax my transcript to the number below. I understand that fax transmission cannot be guaranteed. I hereby release Heartland Christian College from any and all liability involved in faxing my transcript. A mailing address for the fax recipient must be provided above; an official copy will also be sent to the recipient via US Mail.

Fax #:

Attn:

 

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