Official Transcript Request

Transcript Request Form

Transcripts can ONLY be picked up or mailed with this form. To have transcripts sent electronically or to pay online you can place an order with Parchment. Transcripts can be paid for online with Parchment and picked up, mailed, or sent electronically.

Please contact the Records Office if you have any questions about this form.

records@dacc.edu
217-443-3222 options 132
Name & Identifying Information
Full Name

First NameLast Name
Do you have any other last names?
Other Last Names
Other Last Names
Other Last Names
Do you need to add more?
Other Last Names
Other Last Names
Other Last Names
Date of Birth

MonthDayYear
Date
Do you have any DACC records before 1992?
Please provide your student ID number OR your social security number.
Student ID Number
Your seven digit ID number with the leading zero,
Social Security Number
Contact Information

We will use this to contact you if there any issues when processing your request. The primary contact method will be email.
Email Address

Confirmation Emailexample@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Who are the transcripts for?
When should transcripts be sent/prepared?
Transcripts are usually mailed within 2 business days. If something needs to be sent quicker please contact the receiving institution to see if they will accept an electronic transcript which can be ordered through Parchment.
Which semester needs to be posted to send the transcripts?
Number of Copies - There is a $10 fee* per copy. Please call 217-443-8767 to pay before submitting the form.
*There is a transaction fee for using a card.
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Recipient Name (if sending to an institution/third party)
Recipient Address (if sending to institution/third party)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Special Instructions (optional)
If someone else is picking up the transcript this must be specified here and the person must show ID when picking up the transcript.
Authorization Signature
Should be Empty:

Transcript Request Form

Name & Identifying Information

Please provide your student ID number OR your social security number.

Contact Information