Fillable School Records Request Form printable pdf download

School Records Request Form

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RECORDS REQUEST FORM

Buncombe County Schools

$10.00 Non-Refundable

Faxed or emailed

Student Services Department

Fee Required in Cash,

requests not

175 Bingham Road, Asheville, NC 28806

Check or Money Order.

accepted.

Phone 828-255-5918

Today’s Date:

Complete Legal Name while attending school: ______

___

Name currently used, if different:

Father’s Name as listed on school records: __________________________________________________

Mother’s Name as listed on school records: __________________________________________________

Birth Date:

Phone Number:

(We will call if there are problems completing your request)

_______________________________________________

Name of Last Buncombe County School Attended

Years of Attendance: From:

___To:_

____ Did you graduate?

Yes

Records Requested: Please indicate quantity needed in space provided. (Diploma copies are not available)

Official High School Transcript –

Contains high school graduation facts and immunization records, if available.

Graduation Verification –

orm letter stating only your name, high school, date of graduation.

Immunization Records

Complete Record –

Can be used for immigration or identification purposes.

____ Other –

____________________________________________________________

Please describe

Will Pick Up On __________________

Mail Records To: _________________________________

Records Requests take 1 – 2 business days to process,

____________________________________

and up to 5 days during high volume seasons.

______________________________

*THE SIGNATURE MUST BE NOTARIZED WHEN

A PERSON DOES NOT APPEAR IN PERSON AT

Student’s Signature*: _____________________________________________

BUNCOMBE COUNTY SCHOOLS STUDENT

SERVICES unless the records are being mailed

SWORN TO AND SUBSCRIBED BEFORE ME

directly to colleges/universities or are

requested from colleges/universities.

(Notary Seal)

This ________day of _____________, 20_______

In accordance with the Family Educational Rights

and Privacy Act of 1974, it is the express condition of

Notary Signature:____________________________

this institution that this transcript will not be released

to any individual, agency, or organization without the

My Commission Expires:______________________

notarized written consent of the student

For Office Use Only:

Driver’s License #___________________________

Amount Paid

Cash

Check #_________________

Exp. Date_________________ Verified _________

Processed_____________

School Records Request Form

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