(Form to be used if you want your DACC Academic Transcript)
Regulations Governing the Issuance of Transcripts:
| Name: ________________________________________________________________________
Last First Middle |
| Name(s) Used When Attending DACC: ______________________________________________ |
| Social Security Number: _______________________________ Birth Date: __________________ |
| Current Address: ________________________________________________________________ |
| _____________________________________________________________________________ |
| Current Phone Number: __________________________________________________________ |
| Did you attend DACC before Summer 1992? ___YES ___NO |
| Have you ever had a copy of your transcript given to you or had one mailed? ___YES ___NO |
| Student Signature: ________________________________________ Date: __________________ |
| Total number of transcript(s) requested: ________________ Fee Enclosed: $__________________ |
| _____ Give my transcript to me (or) |
| _____ Send my transcript to: |
| _____________________________________________________________________________ |
| _____________________________________________________________________________ |
| _____________________________________________________________________________ |
| _____________________________________________________________________________ |
| When should transcript(s) be sent?
_____ Now _____ After semester grades are posted for the ____________ semester. _____ After degree has been posted for the ____________ semester. |
| Please return to DACC, Records Office, 2000 East Main Street, Danville, IL 61832 or fax to (217) 443-8337. |
| FOR DACC OFFICE USE ONLY:
This transcript was sent on: __________________________ By: __________________________ |