REQUEST A TranscRipt

DO NOT FILL OUT THIS FORM FOR EDUCATION VERIFICATION

All Education Verifications are to be emailed to Bu****@**********tc.edu (May take up to 10 business days). We do NOT accept Education Verification requests by fax! Education Verification requests are to be sent to Bu****@**********tc.edu.

"*" indicates required fields

I attended LCCTC as

an adult Student

a high school student

LCCTC Program Name*

Student Name*

Maiden Name (if applicable)

Class Number or Graduation Date*

Please Send My Transcripts to:

Facility Name*

Attention:

Phone

Facility Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Special Instructions

Your Current Information

Your Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Phone*

Your Email*

Date

Comments

This field is for validation purposes and should be left unchanged.