LON MORRIS COLLEGE—Transcript Request Form

LMC ID # (if applicable) or DOB (MM/DD/YY)                                         Date/Semester last attended                                   

Name                                                                                                                                                             

First                                         Middle                   (Maiden or last name while at LMC)  Last

Current Address:                                                                                                                                               

Street/PO Box

City                                                      State                                                       Zip Code

Phone number                                                                                           Email address

PAYMENT INSTRUCTIONS & CONFIRMATION:  

Payment may be made by via Paypal through the LMC website OR by mailing cash, check or money order to LMC current address (600 College Ave., Jacksonville, TX 75766)

Paypal Payment Amount                     Paypal Confirmation Number                       Date of Paypal payment

Payment Method (Check/Cash/Money Order if not using Paypal)                    Amount of Payment        

Transcript details:

Please send                 copy/copies of my transcript to:              ($5.00 for each Official Transcript)

University/College/Other

Attention

Mailing Address

City/State/ Zip Code

Transcript requests will not be processed for any person until the Student’s account with the college is clear.

Student Signature                                                                    Date

FOR OFFICIAL USE ONLY

Transcript Fee        _____________________                                    Mailed/Picked Up ____________________

Amount Paid                                                                                               Received by                                                 Initials                     

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