Transcripts - The Norseman

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ndependentScchoolDiistrict
Requesst/ReleaseeforStudeentTransccript
Fillo
outtheformbelowtoobtainacopyofa studenttransscript.Aparen
ntmayrequesstacopyofth
heirchild’straanscriptonlyiif
8andthereforeconsidered
daneligiblesttudentunder FederalLaw..Oncethechiildreachesthe
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ageo
of18therightssarepassedfrromtheparen
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uedpictureID
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dertoobtain aanyrecords.A
A
Agovvernmentissu
stand
dardtranscrip
ptcopychargeeis$2.00forccurrentstuden
ntsand$5.00 forformerstu
udents.Ifmulltiplecopiesarremade,there
willb
beapriceincrreaseof$2.00percompletecopy.
Stud
dentName_________________________________________________________________________________________________________________
(OfficialNameasiitappearsonSch oolRecords)
Birth
hdate_______________________________S
StudentID__________________________ G
Graduate
YesorNo
LasttSchoolAtteended___________________________________________________ LastYeaarAttended
d__________________________
PerssonRequesttingRecord_________________________________________________________________________________________________
RelaationshiptoStudent_____________________________________________________________________________________________________
Address________________________________________________________________
_______________________________________________________
City,,State,ZipC
Code________________________________________________________________________________________________________
Phon
neNumber________________________________________________ FaxNumber_____________________________________________
ReassonforRequ
uest__________________________________________________________________________________________________________
#OfficialTranscriptss:_______________________ #Un
nofficialTraanscripts:______________________
___________________________________________________________________________________________________________________________________
Isreecordtobem
mailedorfaaxed,pleaseechecktheaappropriateebox:
___________Maail
___________Fax
Recordw
willbesenttoaddressorfaxnumb
berlistedab
bove.
Pick
kedupby__________________________________________________________________
(S
Signatureofpersonreceivin
ngcopiesofth
hestudentfilee)
D
Date___________________________________
Igivvepermissio
onfor________________________________________________________________________________________________________
Namee(MusthaveV
ValidPhotoID
D) R
RelationtoStu
udent
topiickupmyreecordsasreequestedab
bove(Musth
haveacopyyoftheStud
dent’sPhoto
oID).
_______________________________________________________________________
____________________________________________
Signatture D
Date
uestTakenBy___________________________________________________________
Requ
Fo
or Office Use On
nly Datee___________________________________
Coompleted By: ______________________ Timee_________________________________
Daate: ______________________________ Paaid: