GADSDEN CITY HIGH SCHOOL

GADSDEN CITY HIGH SCHOOL

TRANSCRIPT REQUEST FORM

FILL OUT THIS FORM COMPLETELY (Including Full Address of Receiving School) THERE IS A $3.00 CHARGE FOR EACH TRANSCRIPT.

Today's Date________________________________ Student's Full Name_________________________________________________________

(Give the Full Name Used in High School) Student's Date of Birth_______________________Phone #_________________________ Graduation Date:_______________________________Current Grade_________________ Signature__________________________________________________________________

Fill in One of the Following: Give Transcript Back Sealed to:_________________________________________ Mail Transcript to: Name of School_____________________________________________________ Street Address______________________________________________________ City_______________________________State_________Zip Code____________

Fax to: Name of School_____________________________________________________ Fax Number________________________________________________________

FOR OFFICE USE ONLY--DO NOT WRITE BELOW

Check One:

_____Mailed to School/Employer/Student _____Returned to Student/Parent/Other _____Given to Appropriate School Personnel _____Other_______________________________________

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Date Request Filled

__________

Paid

__________________________________

Signature of Person Filling Request

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