Center Point - Urbana High School Request for Records / Transcripts
This form is to be used to request all records from the Center Point-Urbana, Center Point and Urbana High School record archives.  Any questions should be directed to the High School Counseling Office by emailing transcripts@cpuschools.org or by calling 319-849-1102 X 91210. 

*Official transcript of a student's academic record will be released only to accredited schools, colleges, institutions, agencies or potential employers.*
Sign in to Google to save your progress. Learn more
Requestor Name / Email Address *
Please list the name of the individual requesting the records. Include full name and email address. 
Student Name *
Please include the students registered name while enrolled in the Center Point - Urbana, Center Point or Urbana Community School District.  
Date of Birth (mm/dd/yyyy) *
Date or Year of Graduation *
Name of School or Location for Records to be sent *
Please include school address or email address of where records are to be sent. 
Name of School or Location for Records to be sent
Please include school address or email address of where records are to be sent. 
Signature of Parent / Guardian / Legally Responsible Student *
By checking the box below for this transcript release, you agree that transcripts can be sent to the above institutions as well as additional schools, colleges, institutions, or scholarship committees if the student contacts Amy Osborn in the High School Student Services Office and requests a transcript to be sent on their behalf. 
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Center Point-Urbana Community School District.

Does this form look suspicious? Report

Google Forms