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ITI Technical College TRANSCRIPT REQUEST FORM Please Print Clearly All Blanks Must Be Completed Student Name Last First Middle Social Security Street Address City Phone Number with Area Code State Zip Code Program of Study E-mail Years Attended or Graduated If unknown use approximate dates The first Transcript is free all others are 3. 00 each We accept only Discover Mastercard and Visa Credit Card Number Expiration Date Total number of Transcripts requested Amount Paid Billing Zip Code from CC Cardholder s Signature Number of Transcripts to be sent Mail Transcript To Name/School/Organization For Additional Addresses use page 2 Signature of Student Date Required Fields Please Mail or Fax Transcript Request To Transcript Request 13944 Airline Highway Baton Rouge LA 70817 Phone 225 752-4233 Fax 225 756-0903 Transcripts are disseminated as long as all financial obligations have been met. The school does not release transcripts on any previously enrolled student who has not met their financial obligations to the school as determined by the Accounting Department. 00 each We accept only Discover Mastercard and Visa Credit Card Number Expiration Date Total number of Transcripts requested Amount Paid Billing Zip Code from CC Cardholder s Signature Number of Transcripts to be sent Mail Transcript To Name/School/Organization For Additional Addresses use page 2 Signature of Student Date Required Fields Please Mail or Fax Transcript Request To Transcript Request 13944 Airline Highway Baton Rouge LA 70817 Phone 225 752-4233 Fax 225 756-0903 Transcripts are disseminated as long as all financial obligations have been met. The school does not release transcripts on any previously enrolled student who has not met their financial obligations to the school as determined by the Accounting Department.

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