Eastern Iowa Community College District Academic Transcript Request Form

Be advised that we can not send an Official Transcript directly to you. If you need a copy for your use please request an unofficial transcript, which contains the same information.   The output of this form, when submitted, is transmitted over the Internet in clear text. If you would prefer not to use such a form you may request your transcript using the instructions on the Official Transcript Request page.   Fields with a  *  are required.   *  Choose Your College:     Clinton Community College  (contact information)     Muscatine Community College  (contact information)     Scott Community College  (contact information) * Last Name:  * First Name:    Middle Name/Initial:    Former Name(s):    Maiden Name:  * Date of Birth:  (in the form mm/dd/yyyy)  * Last 4 Digits of Social Security Number:  * Address:                   * City:  * State:      * Zip:  * Telephone:  (please include your area code)  * Email:  * Please list years of attendance:  (separate multiple years with commas)    *  Please send my transcript:     Now   After the indicated term:     Fall   Winterim   Spring   Summer   After my degree is posted. I expect to graduate in:     May  August  December Of year:      Send other time:  (explain)     *  Send my transcript to:   Ashford University   Capella University   Iowa State University   Iowa Wesleyan College   Palmer College of Chiropractic   St. Ambrose University   St. Ambrose - ACCEL   University of Iowa   Trinity College   University of Northern Iowa   Upper Iowa University   Western Illinois University   Other College or University  Name of other college or university:    Department:    Address:    City:    State:      Zip Code:    PLEASE NOTE: Be sure to print out the next screen to have a copy of this form for your records.