JSerra Catholic High School
TRANSCRIPT REQUEST FORM
Please note:
For Office Use OnlyPicked Up
Faxed Date:______
Mailed
Electronic Date:______
· This form may be submitted by mail, facsimile, or in-person.
· Please provide all required information and print legibly.
· Transcript requests will be processed within approximately two working days.
· Transcripts become unofficial if seal is broken.
· PLEASE PUT COLLEGES WITH UPCOMING DEADLINES FIRST
STUDENT INFORMATION
Last Name / First Name / M.I. / Date of BirthMailing Address / Telephone Number
()
City State Zip / Fax Number - if applicable
()
JSerra Enrollment Date / Month/Year of Graduation / E-mail Address
/ / /
TRANSCRIPT PROCESSING INFORMATION
Number of Copies / Type of Processing / Transcript to beOfficial Transcript - $10.00- unlimited per single school
Unofficial Transcript – NO CHARGE / Picked Up
Faxed (unofficial only)
Mailed or Electronic
Mailing Address for Transcript(s): / Additional mailing addresses
Common Application School
Deadline:______ / Common Application School
Deadline:______
School Name / Institution
/ School Name / Institution
Contact (i.e., Admissions Office)
/ Contact (i.e., Admissions Office)
Street Address / Street Address
City State Zip Code / City State Zip Code
Common Application School
Deadline:______
/ City State Zip Code
Common Application School
Deadline:______
School Name / Institution
/ School Name / Institution
Contact (i.e., Admissions Office)
/ Contact (i.e., Admissions Office)
Street Address
/ Street Address
City State Zip Code / City State Zip Code
Please sign to authorize release of the transcript(s) / Method of Payment
I HAVE REVIEWED AND VERIFIED THAT MY TRANSCRIPT IS CORRECT.
______
Student’s Signature Date /
Check Number: Amount: Waiver: ______
Must be signed by the Business Office
Cash: Amount: