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Stark State College
Gateway Student Services
6200 Frank Ave NW, North Canton, OH 44720
(330) 494-6170 | Fax-(330) 966-6598
www.starkstate.edu | studentservices@starkstate.edu
# OFFICIAL TRANSCRIPT REQUEST Akron School of Practical Nursing Please print in blue or black ink only Student name Date of Birth _____ Last 4 Digits of SSN ___ Former Name(s) ___ For SSC Students: Name changes require documentation (i.e. Social Security card, driver's license, legible court documentation) Current Address ___ City, State, Zip Code ___ County ___ Telephone Number ___
BOX A Email transcript to:BOX B Mail transcript to:
Name:Name/Institution:
Email:Address:
I hereby authorize Stark State College to release my Akron School of Practical Nursing academic transcript. Photo ID required for pick-up. Student Signature ___ Dat Date
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FOR OFFICE USE ONLY Processed Date _____ Initials _____