Official High School Transcript Request
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Student Last Name
Student First Name
Student Middle Name
Student Maiden Name
Date of Birth
Graduation Year
Current Mailing Address (Street, City, State, Zip)
Current Phone Number
Email Address
Method of Delivery
Mail To:
Fax To:
Preferred Notification for Transcript Pick Up
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Reason for Request of Student Record:
Authorization Notification:  My signature below authorizes McDowell Early College to release information and / or my student record and confirms I have completed all sections accurately and truthfully, including information verifying my identity. I understand that the recipient of the record(s) will use the indicated documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other part or agency without my expressed written consent except under authority of Public Law 93-380, Educational Rights and Privacy Act. I understand that an incomplete form will not be processed and will be considered closed after expiration of the 30 day notification window. I declare under penalty of perjury that the foregoing is true and correct.  Please enter your electronic signature below.  
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