Wellsville High School Transcript Request Form

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I herby authorize Wellsville High School to release the transcript of my academic record.
* Required

Email *

Name: First and Last *

Email Address *

Step 1: I have agreed to submit this application by electronic means (If you are unable to submit electronically please print, mail or fax the form into the school). By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. The transcript of an academic record is an "education record," as defined by P.L. 93-380. In addition to academic information, it may contain personally identifiable and directory information such as date of birth, high school graduation date, etc. Except as provided by law, a transcript is only released upon prior written consent of the student. *

By checking this box and typing my name below, I am electronically signing my application.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

I give my permission to send ACT/SAT Scores

Required

Step 2: Type your name below to represent your electronic signature. *

Today's Date: *

YYYY

Mail Transcript to: (Please provide the full address you wish your transcript to be sent)Please check with your university, college, or trade school for the manner in which they require your transcript and select one option of delivery.

Fax Transcript to: Provide name of recipient and name of school (This option, most time is not recognized as an official transcript) Please check with your university, college, or trade school for the manner in which they require your transcript and select one option of delivery.

Email Transcript to: Provide name of recipient and name of school (This option, most time is not recognized as an official transcript) Please check with your university, college, or trade school for the manner in which they require your transcript and select one option of delivery.

Note: Transcripts sent directly to a student and/or emailed or faxed are marked "unofficial"; a third party may not accept these transcripts. * *

I acknowledge the above statement

Required

Graduation Year: Non- graduates, list the year attended. *

Full Name: First Middle Last *

Maiden/Former Names(s):

Current Address: *

City, State, Zip Code *

Phone Number: *

Date of Birth: *