Prospective Student
Please complete this form and send to school attended
| (please print) |
Social Security No.
Name
Address
City
| State
|
Zip |
State
Scool Attended
Last year attended
Birth date
Former legal last name
| (cut here) |
Transcript Release
I hereby authorize
to release all testing information on file and a certified copy of my:
| (name of institution releasing transcript) |
(check one of the following boxes)
| High school transcripts |
| College transcripts |
| G.E.D. scores |
to: Des Moines Area Community
College
Admission Processing
- Building #1
2006 South
Ankeny Boulevard
Ankeny,
Iowa 50021
Signed