Records Release Form - Jericho High School

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Please note: There is a minimum of 10 school days to process your application once your transcript has been approved
.
JERICHO HIGH SCHOOL COUNSELING CENTER
RECORDS RELEASE FORM
Student’s Name:
Date of Birth
______________________________________
: ___________________
Teacher Recommendations (Please list in priority order):
1.______________________________ 2.____________________________
Before your transcript can be sent, the following steps need to be completed:
Review and approve your high school transcript found on the Student Records page.
Return the signed copy to Mrs. Wright in the Counseling Center.
Sign the FERPA Waiver & Authorization on the Common Application.
Go to the “Colleges I’m Applying To” section on Naviance and complete the Common App
Account Matching process.
Make sure all colleges below are listed in the “Colleges I’m Applying to” section on Naviance
(Including all those colleges not on the Common Application)
PLEASE RELEASE MY RECORDS TO:
ED, EA
Application
Special Instructions
Office
Name of College/University
Priority, Rolling
Deadline
(if applicable)
Use Only
or Reg.
I understand that it is my responsibility to request that an official copy of my SAT and/or ACT scores be
sent directly to all institutions listed above.
I am requesting that my official transcript and letters of recommendation be sent directly to the
colleges/universities listed above.
____________________________________
Date: ______________________
Student’s Signature
___________________________________
Date: ______________________
Parent’s Signature
Guidance Office Use Only:
Counselor: Transcript Reviewed: _____________
Date Received: __________
Date Sent: __________
Colleges Added: ______ Letter Completed:______

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