Dryden High School Transcript and Information Request Form
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Dryden High School Counseling Office
(607) 844-8694 EXT: 5226
Student's Full Name (maiden name) *
Date of Birth *
MM
/
DD
/
YYYY
Year Graduated/Last Attended *
Email: *
Phone number: *
Records you would like sent *
Please send records by *
Please send my transcript /Information to:
Person
College / University, Business
Street Address/PO Box, City, State/Province, Zip Code
Country (if not USA):
 *

Signature of Requesting Person (must be the requesting person, unless 17 years or younger)  I, the requester, of this Record Request, warrant the truthfulness of the information provided in this application.

Please type your First and Last Name:

 *
I understand that by checking the box below constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *
Required
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