Transcript Request Form
Transcript Request Form
Rev. 2018
2127 Himrod Street
Ridgewood, NY 11384
Request for Records
Date:___/___/___
Last Name First Name
Name You Attended Under If Different From Above: Phone #:
Address: City __________ State ___ Zip Code
Date of Birth:
Dates of Attendance: or Currently on Register
Date of Graduation or Date of Discharge
Please check requested documents: School will accept money orders or cash ONLY no checks
Official Graduate Letter Certifying Graduation (in lieu of copy of diploma) - $ 5.00
Immunization History (If attended this school after September 1980) - No Charge
Transfer Papers to attend another New York City high school - No Charge