Transcript/School Records Request Form
Please complete and submit the following form to request a transcript or school records. There will be a $5.00 processing fee per transcript/record. Cash, check, money order, credit or debit are accepted. There is a $.13 processing fee for credit and debit card transactions. Please be prepared to show a photo id, and allow 24 hours from the time of the request to complete the transcript/records request. If the student is over 18 years of age, the request for transcripts or school records may only be made by the student. For additional information please call our student records clerk at 316-788-8421.
***Derby Public Schools comply with the FERPA and HIPPA Privacy Acts.***
Full Legal Name
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Maiden or any other name used while in attendance.
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Date of Birth
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Daytime phone Number
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E-mail Address
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Year of graduation OR last year attending Derby schools?
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Derby school you last attended:
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Requesting Information: (check all that apply)
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Receiving Records
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If requesting records be mailed or faxed, please enter mailing address or fax number below.
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