Hamilton Technical College

I, (please print)                                                                                  request a copy of my HTC transcript from my file for my use.

Social Security Number                 /             /                        

Dates of attendance:                                        to                                        

Did you graduate? (circle one)  YES   NO

Program enrolled in (circle one):  EET   CAD   MA   MBC   CIM

Student's Signature                                                                                             

Today's Date                                                      

Your Current Address

Phone Number (                 )                      -                               

Mail Transcript to:

            Myself

            Other

Address of Other:

Is this your first request for a transcript? (circle one)  YES   NO

Number of copies you are requesting?