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AZ Kelsey Academy Transcript Request Form
Please complete this form in its entirety. Each transcript costs $5. Your request will be processed once this form is completed and payment is made. Please go to the AZ Kelsey office and see Mrs. Kendall for payment. Please do not hesitate to contact Mrs. Kendall or Mrs. Zokovitch if you have any questions at (770) 229-4365.
Email address *
Student Name
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Today's Date
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DD
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YYYY
Student Address
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Student Phone Number
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Student Email Address
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Student's Birth date
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DD
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Student's Present Grade or Date Attended
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AZ Kelsey Academy has been requested to send transcripts for the above student to:
1. Name of Institution
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Institution Address
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2. Name of Institution
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Institution Address
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3. Name of Institution
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Institution Address
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Please be advised that it may take four weeks to post final grades for a given semester. Please allow up to (3) days for a transcript to be processed. First official transcript is free. All other transcripts will require a $5.00 prepayment.
Parent Signature (Your electronic signature serves as your consent to this request)
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Student Signature (If over age 18, your electronic signature serves as your consent to this request)
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A copy of your responses will be emailed to the address you provided.
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