TRANSCRIPT/DIPLOMA REQUEST

Transcript/Diploma Request Form

Use this form to request a a copy of your transcript and or diploma/certificate. To view IIC's chosen name policy please visit: Chosen Name Policy

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Name*

First Last

Has your legal name changed since attending school?*

Yes

No

Name while attending school*

First Last

Name Change Document*

Please upload supporting documentation: State ID, Driver's License, court order, marriage certificate or name change affidavit.

Max. file size: 50 MB.

Address*

Address where we should mail transcript, diploma/certificate to:

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Date of Birth*

To verify identity

Program*

Select the program completed at IIC.

Signature*

Processing Fee:*

Processing fee includes mailing cost.

Credit Card

632 Silas Deane Hwy
Deane Wethersfield, CT 06109

657 Silas Deane Hwy
Wethersfield, CT 06109

65 Whiting St
Plainville, CT 06062