Henry-Senachwine High School Transcript Request
Please complete the following information to initiate a copy of your high school transcript to be sent.
Name of Student *
Your answer
Maiden Name of Student
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Graduation Year *
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Student Current Street Address *
Your answer
Student Current City *
Your answer
Student Current State *
Your answer
Student Current Zip Code *
Your answer
Name of Transcript Recipient (Name of college, school, person, company, etc.) *
Your answer
Recipient Street Address *
Your answer
Recipient City *
Your answer
Recipient State *
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Recipient Zip Code *
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Recipient Fax Number
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Student Phone Number or email address (in case questions arise) *
Your answer
By entering your initials on the line below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
Your answer
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