Home School Transcript Form
Grace C ollege A dmissions|200 S eminary D rive|Winona L ake, I N 4 6590
admissions@grace.edu|574.372.5100 e x. 6 008|574.372.5120 ( fax) |
Parent/Supervisor c ompletes t he f ollowing:
Student I nformation:
Name/Title______________________________
Last N ame_______________________________
_______________________________________
First N ame________________ M iddle I nitial___
School N ame ( if a pplicable)
Gender_________ D ate o f B irth_____________
_______________________________________
Email___________________________________
Graduation D ate: _ _______________________
Home A ddress___________________________
Cumulative G PA:_______ G rading S cale:______
City___________________ S tate____________
Total C redits E arned:______
Zip________ P hone ( ___) _ _________________
Freshman Y ear: 2 0__ -‐ 2 0__
Sophomore Y ear: 2 0__ -‐ 2 0__
Course N ame
Grade
Credit
Course N ame
Grade
Credit
GPA:__________
GPA:__________
Junior Y ear: 2 0__ -‐ 2 0__
Senior Y ear: 2 0__ -‐ 2 0__
Course N ame
Grade
Credit
Course N ame
Grade
Credit
GPA:__________
GPA:__________
ACT/SAT T est S cores & T est D ate(s):_______________________________________________________
*In a ddition, t he t esting s ervice m ust s end o fficial s cores t o G race C ollege
_____________________________________________________________________________________
Supervisor S ignature______________________________ D ate___________ P hone_________________