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Transcript Request Form 4

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8 views

Transcript Request Form 4

Uploaded by

ogutuisaiah1
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Kent County Public Schools

5608 Boundary Avenue


Rock Hall, Maryland 21661
_________________________
Attn: Laura Johnson
Office of Student Services
410-778-7138
410-778-2896 (fax)
Form can be emailed to: [email protected]

TRANSCRIPT REQUEST

Print Full Name Date of Birth

Maiden Name (if applicable) Graduation Date

Contact Phone Number Last Kent County School Attended

Please MAIL a copy of my transcript to: Please E-MAIL/FAX a copy of my transcript to:

Please also MAIL a copy of my transcript to my


address: (Complete if you would like a copy.)

THERE IS NO COST FOR THIS SERVICE.


My signature acknowledges notification of this transfer of records as required by the Family Educational Rights and Privacy
Act of 1974 and my understanding that I have a right to receive a copy at my own expense, if requested, and have an
opportunity for a hearing to challenge the content of the records. I understand that the information transferred will be treated
in a confidential manner and will not be transmitted to a third party without my consent.

Transcript information may include PSAT/SAT/ACT data.

Signature: Date
(of student if age 18 or older)
(of legal guardian/parent if student is under 18 years of age)

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