Wynne Public Schools



Wynne High School

P. O. Box 69

Wynne, AR 72396

Phone: (870) 238-5070

Fax: (870) 238-5009

HIGH SCHOOL TRANSCRIPT REQUEST

PLEASE ALLOW 2 BUSINESS DAYS TO PROCESS REQUEST

I am requesting a copy of my high school transcript for the following reason:

| |      |Personal Use | |      |College/University Admission |

| |      |Insurance | |      |Scholarship Applications |

| |      |School Transfer | |      |Other |      |

PLEASE PRINT:

|Date: |      | | |

| |

|Student Full Name: |      |

| |

|Contact Number: |      |

| |

|Maiden Name (if applicable): |      |

| |

|Student ID: |      |Current Grade: |      |

| |

|Last 4 Digits of SSN #: |      |Date of Birth: |      |

| |

|Year of Graduation: |      |If Not, Last Year Attended: |      |

| |

|Childress High School |      |Parkin School District |      |Wynne High School |      |

| |

|Student Signature/Applicant Signature: | |

|Please select one of the following: | | |

| |

|      |Will Pick Up | | | | |

|      |Please mail copy to the following: | | |

| | |

|Name of school/institution: |      |

|Attention: |      |

|Address: |      |

|City, State, Zip: |      |

| |

|FOR OFFICE USE ONLY |

|Transcript mailed/pick up/faxed | |Initial of person sending transcript | |

|Date: | | |

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