Transcript Request
Student Last Name (upon graduation) *
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Student First Name (upon graduation) *
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Student Middle Initial (upon graduation)
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Student Birthdate *
mm/dd/yyyy
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Choose from below *
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Year Graduated or Withdrawn *
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Last LPS School Attended *
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Student Current Name *
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Daytime Phone *
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Documents(s) Needed *
Check all that apply
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Mail Records To: *
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Additional Comments
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I authorize the release of my school records, as directed above *
Type current full legal name
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Type the full legal name of your parent/guardian *
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