REQUEST FOR OFFICIAL TRANSCRIPT BY FAX
(NO FEE REQUIRED)

To request an official transcript via fax, print the form below, fill out the information and fax ( 903. 693. 2031) along with a copy of a photo ID that bears your signature (drivers license, school ID) to:

Panola College
FAX - (903) 693-2031

(Please Print)

_____________________________________________________________
Last Name, First Name, Middle Initial

_____________________________________________________________
Street Address

_____________________________________________________________
City, State, Zip

____-___-______ _____ / ____ / ______ (____)____________
Social Security No.    Date of Birth Day Phone Number
 
____________________________________
Previous Name(s) Enrolled Under
____________________________
Last Date Attended Panola College

____ Number of Copies Requested                                         
____ Mail Transcript to Address Below
____ Mail After Grades are Posted (check one below)

Fall Spring

Summer I

Summer II
 
Mail Transcript to:
 
______________________________________________________
Name
______________________________________________________
Address
______________________________________________________
City, State, Zip

______________________________________________________
Your Signature and Date