Transcript Release Authorization Form

Transcript Release Authorization Form
Please take note of the following:
- Parent/Guardian must submit this Transcript Release Authorization Form if the student is under 18 years of age.
- A student is entitled to 1 copy transcript for the first request. Subsequent copy requests shall cost two dollars per copy.
Student Number
Name of Student
First NameLast Name
Address of Student
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Status
Last School Year Attended
Please upload a copy of a valid ID of the student enrolled
Cancelof
I hereby authorize the school to send my transcript of records to:
Name of Receiving School
Address of Receiving School
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Signature
Clear
Name
First NameLast Name
Date
MonthDayYear
Date
Should be Empty: