TRANSCRIPT REQUEST FORM

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Last Name *

First Name *

Middle *

Maiden Name ( if applicable) *

Current Address *

Phone Number *

Year Graduated from DPHS *

If you did not graduate from DPHS, list the last year attended *

Would you like this to be mailed via US post office or Emailed? *

Hard Copy

Please indicate the name of the person/college & address to which the transcript is to be sent along with address (physical or email): *

Please list any email address you would like the transcript to be sent to:

The purpose of this Transcript Release is for me to *

apply to college or pursue higher education

transfer to another high school

enlist in the armed forces

obtain employment

Other:

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