New Mexico Scholarship Transfer Transcript
If a student has ever attended another NM public post-secondary institution and received a NM Lottery Success, NM Scholars,
Legislative Endowment, or any other tuition based scholarship, the institution the student is transferring from will, upon student
request, submit this form to the Financial Aid Office of the institution the student is planning to transfer to. Note: The student should
request academic transcripts from each NM public post-secondary institution that they have previously attended. The transcript(s)
should be sent to the financial aid office the student is planning to transfer to.
Last:
First:
High School Name / City:
or
New Mexico GED Testing Site:
Colleges / Dates Attended:
SSN:
/
-
-_______
Month / Year Graduated:
/
Date Completed:
/
/
1.
/
2.
/
3.
/
4.
/
Institution Transferring To:
Institution Transferring From:
San Juan College
4601 College Blvd.
Farmington, NM 87402
Phone: (505) 566-3323
Fax: (505) 566-3593
FAX:_
___
Information below this line will be completed by the Financial Aid Office.
NM Lottery Scholarship
New Mexico Scholars
Legislative Endowment
Qualifying Semester: ___________
Terms Awarded:
Qualifying Semester:_________
Terms Awarded:
Qualifying Semester: ______
Terms Awarded:
Fall_________ Spring _________
Fall_________ Spring _________
Fall_________ Spring__________
Fall_________ Spring__________
Fall_________ Spring__________
Fall_________ Spring__________
Fall_________ Spring__________
Fall_________ Spring__________
Fall_________ Spring__________
Comments:___________________________________________________________________________________
____________________________________________________________________________________________
Is student still eligible for state based program listed above?
____________________________________________
Authorized Signature
____________________________________________
Printed Name and Title
____________________________________________
Address
Yes
No
_____________________________________________
Date
_____________________________________________
Name of Institution
_____________________________________________
Telephone No./Email Address