Clarke County School District
Date_____________________
Fill in name and address of recipient to ensure document is sent to the right location or given to the person you authorize to receive your transcript.
________________________________________________________
________________________________________________________
________________________________________________________
OR
FAX Number of Recipient: _____________________________________
Student’s name during time of attendance at CCHS:
Name: _________________________________________________________
DOB: _____________________________ Last four digits of SS#_________
Year graduated ______________ or last year attended________________
Phone Number [in case of question(s)] ____________________________
_____________________________________________________________________
Parent Signature (if current student)
_____________________________________________________________________
Student Signature (required for all graduates or former students)
The $5.00 fee payable to Clarke County High School is required from all alumni and organizations making a request. Transcripts will be mailed or faxed within 48 hours upon receipt of fee.
Received by: ______________
Transcript mailed on: _______________ by: ___________________
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