Florence-Darlington Technical College

Admissions Office

PO Box 100548

Florence, SC 29502-0548

843.661.8159

TRANSCRIPT REQUEST FORM

Please send an official transcript, including proof of graduation, and SAT/ACT scores (if available) for the following student to:

Admissions Office

Florence-Darlington Technical College

Post Office Box 100548

Florence, South Carolina  29502-0548

 

STUDENT INFORMATION

 

 

 

Student Name:  Last, First, Middle

 

Social Security Number

 

Maiden Name (if applicable)

 

Date of Birth

Date of Attendance: 

 

-

 

 

From

 

To

Check Applicable Term:

o

Fall,

      

 

o

Spring,

 

 

o

Summer,

 

 

 

 

Year

 

 

 

Year

 

 

 

Year

 

INFORMATION RELEASE AUTHORIZATION

I understand that it is my responsibility to request any and all transcripts.  These will not be requested by FDTC.  My signature below authorizes release of my transcripts.  I understand that if there are any charges for the transcript, I am responsible for these and should be notified at the address shown below.

 

 

 

Student Signature

 

Date

 

 

 

 

 

 

 

Street

 

City

 

State

 

Zip Code

 

 

 

Phone

 

Email