GREECE ATHENA HIGH SCHOOL



GREECE ATHENA HIGH SCHOOL RECORDS RELEASE FORM

You can mail completed form to: You can e-mail completed form to: You can fax completed form to:

Greece Athena High School angela.owen@ 585 581-8163 or 585 966-4039

Counseling Office

800 Long Pond Road Phone contact:

Rochester, NY 14612 585 966-4044

FORM MUST BE COMPLETED AND SIGNED. IT CAN TAKE UP TO 5 BUSINESS DAYS TO PROCESS.

_______________ _____________________________ _____________________

DATE LAST NAME (Maiden) FIRST NAME

YEAR GRADUATED __________ DATE OF BIRTH _______________

My signature below will authorize Greece Athena High School to send the following records:

Transcript ______ Health Record______ Test Scores______

Send My Records To:

__________________________________________________________________________________________________

_________________________________________________________________________________

______________________ ______________________________ ___________________________

Signature if over 18 OR Signature of Guardian Phone contact

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