Transcript Request Form printable pdf download

TRANSCRIPT REQUEST FORM

Contact Information:

Student Name:_______________________________ Date of Birth: ______________

Year of Graduation:___________ Parent or Guardian Name: ____________________

Home Phone: ________________________ Cell Phone: _______________________

Street Address: ________________________________________________________

City: ______________________________ State: ___________ Zip: _____________

1. What type of transcript do you want?

(indicate the quantity on the line to the left)

Official:

______

this has the official school seal and signature and comes in a sealed

envelope which must remain sealed. If you open it, it becomes unofficial.

Is this for the Common Application? YES

(please circle)

Unofficial:

______

this is simply a record of courses taken at (or transferred into) Santiam,

along with the grades and credits earned. It has the same information as

the official, but does not carry the seal or signature which makes it official.

2. Where would you like the transcript to be sent?

I will not create a transcript if this area is left blank!

_____Have it delivered to me at school.

_____Mail it to my home address as listed in the student directory.

_____Upload it to my Common Application

_____Send it to the following address:

Attention:_________________________________________________________

School or agency name:_____________________________________________

Street address:____________________________________________________

City, State, Zip____________________________________________________

Please fill out a separate form for each address.

3. When would you like the transcript sent?

If this area is left blank, I will send it within 24 hours of receiving the request. If you want a

transcript sent after a certain grading period, or after a certain date, please write that date below.

_____Send right away.

_____Hold this request and send on:____________________________________

Student Signature: __________________________________________________

Parent or Guardian Signature: _________________________________________

(Required if student is under 18 years old)

\\filesvr-01\staff$\BeamS\REGISTRAR\Forms\Transcript Request Form.docLast printed 9/29/2009 9:39 AM

Transcript Request Form