Jones County Junior College
Transcript Request
 

 
Name:   ______________________________________________
 
Name of Record:
(if different)		  
______________________________________________
 
SSNO:   ____________________
 
Dates of Attendance:  
______________________________________________
 
Birth Date:   ______________________________
 
Mail transcript
to this address:		   ______________________________________________

______________________________________________

______________________________________________

______________________________________________
 
Student's Return Address   ______________________________________________

______________________________________________

______________________________________________

______________________________________________
 
Recipient's
fax number:
 
 		 ____________________________ (if applicable)
Daytime Phone
Number:
 		   _____________________________

Email:		  
_____________________________
Your signature:   ________________________________________
(Request will not be processed without signature.)
 
Request Date:   ______________________
   
_____ Please mail my transcript.
_____ Please fax my transcript. (Pay $20 fee by check, money order,
            or credit card. See notes below.)


Mail or Fax to
Student Records
Jones County Junior College
900 South Court Street
Ellisville, MS  39437
Fax: 601-477-4258


Payment Notes:
Transcripts paid by check will be held until the check clears (approximately 5 weeks.)
Credit card payment may be made by calling Student Accounts at 601-477-4010. Clearly indicate the purpose of the payment.