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Proximity Learning Transcript Request Form
Please enter information exactly as you would like it to appear on the transcript. Please note that there is a fee to mail the transcripts internationally.
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Student Full Name:
*
Your answer
Parent/Guardian Name/s:
*
Your answer
Parent/Guardian Email Address:
*
Your answer
Name of Transcript Requester:
*
Your answer
Relationship of Transcript Requester:
*
(i.e. parent/guardian, counselor, facilitator, teacher, school admin, etc.)
Your answer
Email Address of Transcript Requester:
*
Your answer
Name of course(s):
*
AP Latin Course
AP Macroeconomics Course
AP Psychology Course
AP U.S. Government Course
ASL 1 Course
ASL 2 Course
ASL 3 Course
Chinese 1 Course
Chinese 2 Course
Chinese 3 Course
Chinese 4 Course
Elective Course
Japanese 1 Course
Japanese 2 Course
Latin 1 Course
Latin 2 Course
Latin 3 Course
Spanish 1 Course
Spanish 2 Course
Spanish 3 Course
Other:
Required
Name of School District
*
If student is homeschooled please indicate that below.
Your answer
School Contact Information:
Please fill out this section only if you would like the transcript to be emailed or mailed to child's school.
School Contact First and Last Name
Your answer
School Contact Email Address
Your answer
School Contact Phone Number
Your answer
School Contact Mailing Address
Your answer
Acknowledgement of Privacy Policy
Privacy Policy:
https://www.proxlearn.com/ferpa-information-and-policies
By submitting this form I agree that I have read Proximity Learning, Inc. Privacy Policy and consent to the student's transcript being shared with his/her school.
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