Peralta Community College District

Transcript Request Form

TRANSCRIPT REQUEST INFORMATION
Processing Types and Fees:
v  Regular Delivery - $6.00 per copy: mailed within 7-10 business days.
v  Rush Delivery - $12.00 per copy: mailed within 3-5 business days.
v  Pick-up Processing - $12.00 per copy: students pick-up transcripts at the District A&R Office in 2 business days.
v  Free Transcripts - Student’s first two transcripts requested are free. (Regular delivery only)
v  Prior to 1970 processing – Allow up to 20 days (there is no rush for prior 1970 records).
v  Same day transcripts - $25.00 per copy: available after 2 hours – requested in person at the District Admissions Office only.
In-Person/Mailed transcript requests will not be issued/processed if any of the following criteria are not met:
v  Signed and dated written request from student.
v  All Peralta debts must be paid and all holds, including financial holds, must be cleared before transcript requests can be processed.
v  A mailed transcript request must have payment included. Check or money-orders only. Do NOT mail cash or credit card information. Mail Requests to:
Peralta Admissions
333 East 8th St.
Oakland, CA 94604
Note: One transcript will include all courses taken at all Peralta Community College District locations.
ATTENTION: You must make sure that your grades and degrees are posted on PASSPORT before ordering a transcript.
STUDENT INFORMATION
Please print clearly: / Did you attend prior to Fall 1970? YES NO
Name: / Date of Birth:
Last / First / M.I.
Other names used at Peralta:
Address:
No. & Street / City / State / Zip Code
Email Address: / Phone #:
Student ID# OR SSN: / Dates of Attendance:
From / To
SEND TRANSCRIPTS TO:
REQUEST #1 / Number of copies: / Processing Type: Regular Rush Pick-Up Same Day
MAIL TO:
Address:
No. & Street / City / State / Zip Code
REQUEST #2 / Number of copies: / Processing Type: Regular Rush Pick-Up Same Day
MAIL TO:
Address:
No. & Street / City / State / Zip Code
X
Student Signature / Date
ADMISSIONS & RECORDS/CASHIER OFFICE USE ONLY
PROCESSED? / YES NO / REASON:
REQUEST #1: / Mail Pick-up Rush Same Day / REQUEST #2: / Mail Pick-up Rush Same Day
Amount Due: / $ / X
A&R Initials / Date
Amount Paid: / $ / X
Cashiers Initials / Date

Rev.: JBW 10/25/12