Transcript Request Instructions (Page 2 of 2) in pdf

Transcript Request Instructions Page 2

EAST ST. LOUIS SCHOOL DISTRICT 189

TRANSCRIPT REQUEST FORM

$2.00 Processing Fee (Money Order / Cash)

Process may take up to 3-5 business days

Date of request____________________ Social Security Number_______________________

(Print) Your Name: ___________________________________________________________

Last

First

(Print) Last Name _________________________ (while enrolled, if different from above)

Date of Birth: __________________________________

Month

Day

Year

If graduated what year: __________________ OR the last year you attended____________

Last High School attended________________________________________________________

(If you did not complete High School indicate below)

Last Junior High School attended___________________________________________________

Last Elementary School attended___________________________________________________

Please choose one:

Official copy__________

Unofficial copy________

Pick up: ______

Fax: (____) ________________

Send my Transcript to: ___________________________________

___________________________________

Signature: ______________________________________________

Contact Phone Number: (____) _____________________________

Transcript Request Instructions Page 2