Georgia Cyber Academy High School
Student Transcript Request/Release Form
Please complete this form to request that school records be forwarded to an outside entity.
State law requires that pupil records cannot be released without the written consent of a parent,
guardian, or adult student. A Notarized Authorization for Release of Records Affidavit must
be on file at GCA.
Important Notification: Processing time for all transcripts is 10 business days. The cost of all transcripts (with
the exception of students withdrawing from GCA) is $2.00 and the fee must be paid prior to transcripts being
mailed. Details on how to do this are in the document titled: Procedure for Transcript & Recommendation Request
and can be found at Transcripts will not be mailed without the full mailing
address of the receiving entity. After completing this form email it to with a subject line:
Last Name, First Initial, Student ID Number.
Student ID #:
Date of Birth:
Year of Graduation:
Home Phone: (
I have read the above statement and, pursuant to the law – I hereby authorize the release of a
copy of the school transcript to the following agency/institution named below:
Fax NOT to be used for college applications
Post Secondary College/School
Other (state purpose)
PLEASE NOTE THAT STUDENTS ARE RESPONSIBLE FOR REPORTING SAT/ACT SCORES TO COLLEGES
Scores must be requested by student directly from SAT/ACT. SAT/ACT will send scores directly to colleges.
Authorized Adult Signature:
For Office Use Only:
Date Received: ___________________
Date Mailed: _________________
Received By: _____________________
Mailed By: ___________________