REQUEST FOR RELEASE OF HIGH SCHOOL TRANSCRIPT

 

$5.00 Fee for each transcript

 

 

 

 

Name ________________________________________________

Student Name (As shown on school record)

 

 

Date/Year Attended (Graduation date if graduated) ____________________________

 

 

Date of Birth ______________________________

 

 

Release Records to:______________________________________________________

 

                                ______________________________________________________

 

                                ______________________________________________________

 

 

 

 ____________________________________ or _______________________________

               Student Signature                                                Parent Signature

 

 

Date ______________________________________________

 

 

 

Mail to:

Registrar

Dublin High School

1951 Hillcrest Parkway

Dublin, GA 31021