Transcript & Diploma Request Form for Adult Diploma & High School Referral

Transcript & Diploma Request Form for Adult Diploma & High School Referral

Your transcripts will be processed within 3-4 business days.

Please note that you will need to upload a picture of your ID for verification of your identity.

If you have any questions, please call (909) 274-4937

What is your last name?*

What is your first name?*

What is your lived/preferred name? (If different than your first name)

A lived name is a self-chosen or personal and/or preferred name used instead of a legal name (only need to include if it's different than the "First Name" you listed above)

What is your Mt. SAC ID#*

If you don't remember it, please leave as "A0".

What is your birthdate?*

Email*

Cell phone number*

Phone

What program did you attend?*

Adult Diploma - Graduated

Adult Diploma - Did not Graduate

High School Referral

When did you last attend?*

You can list the estimated date, semester, or year. You don't have to be exact.

What would you like to request?*

If you want your transcripts AND diploma, please complete this form twice.

Select

Do you want your diploma mailed to you?*

Please note that we can only give you one copy of your diploma.

Select

Proof of Identity for Diploma*

We require that you submit a picture of your Driver's License, California ID, or other ID to have your diploma mailed to you.

Drag and drop files here or

What is your street address?*

e.g. 1100 N. Grand Ave

What city?*

Which state?*

What is your zip code?*

How many copies would you like sent there?

What college(s) would you like your transcripts sent to?

What high school(s) would you like your transcripts sent to?

How many copies would you like to pick up?

Please list any special instructions or notes

Send me a copy of my responses

Privacy Notice|Report Abuse