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Official Transcript Request Form - Syracuse High School

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OFFICIAL TRANSCRIPT REQUEST FORM

SYRACUSE HIGH SCHOOL

665 SOUTH 2000 WEST

SYRACUSE, UT 84075

Phone: (801)402-7900

Fax: (801)402-7901

PLEASE PRINT CLEARLY

Date ____________________

Please mark one:

Name __________________________________________

_____ Please mail transcript by deadline of _________

_____ Will pick up in person

Student # _______________________________________

Phone __________________

Birthdate __________

Purpose of Transcript

Graduation year __________________

_____ Admission/Scholarship application

_____ Personal use

AP, ACT, and SAT score will be included with all

Mail Transcript to: ($2.00 fee/school)

transcripts.

_____ Brigham Young University (

Provo, Idaho, & Hawaii)

All requests must be completed and signed

_____ College of Eastern Utah

All official transcripts are $2.00 per copy

Please make payment to Syracuse High School. Bring

_____ Dixie State College

this request form in with your payment

Mail your

_____ LDS Business College

request with payment to the above address (attention:

Registrar)

_____ Salt Lake Community College

Please allow TWO WEEKS for processing

_____ Snow College

Only list addresses for colleges/universities not on the

_____ Southern Utah University

list.

_____ University of Utah

_____ Utah State University

I authorize Syracuse High School to release a copy

_____ Utah Valley University

of my transcripts.

_____ Weber State University

_____ Westminster College

Student Signature_________________________________

_____ Other

*Other (only schools not on list)

College/University______________________________________________________________________

Person/Department____________________________________________________________________

Address________________________________________________________________________________

City________________________________

State___________________

Zip Code_____________

College/University______________________________________________________________________

Person/Department____________________________________________________________________

Address________________________________________________________________________________

City________________________________

State___________________

Zip Code_____________

College/University______________________________________________________________________

Person/Department____________________________________________________________________

Address________________________________________________________________________________

City________________________________

State___________________

Zip Code_____________

DATE COMPLETED________________________________

PAID $____________

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Official Transcript Request Form - Syracuse High School

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