AUTHORIZATION FOR RELEASE OF INFORMATION
*** Please allow us at least 3 to 5 business days to process your request. You need to be mindful of the estimated processing time and your institutional/organizational deadlines when submitting this form. This form is primarily used for educational institutions, but you may request documents to be completed for employers and/or other organizations requesting information about your academic and disciplinary history at Montgomery College***
  • Student Information

  • (Ex. M2XXXXXXX)
  • - -
    If we can't reach you by email, please provide your best phone number
  • School Information

    In the section below, please indicate the schools to which you are applying (up to 10), the date when your materials are due, and an institutional email address where your materials can be sent. In addition, please indicate if your request is for a Coalition Application, Common Application, or another "General Form". Please make sure you complete any student required information on your requested documents (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) and then attach them to this form. Incomplete forms or submissions will delay processing time.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • / /
  • Attach the requested document (e.g., Common Application College Report, Coalition Application Transfer Report, etc.) here. Please make sure that you complete any required student information on your form before attaching.
  • Acknowledgement & Signature

  • Please write your signature in the space above using your mouse, a digital pen, or your finger.