Utica Academy of Science Transcript Request Form

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Student's Information

First Name *

Last Name *

Date of Birth *

YYYY

Phone *

Email *

Other Name(s)

Did you graduate from UAS? *

Yes

Years Attended - From

Years Attended - To

Authorization

I authorize the release of my official records to the Institution/Agency listed below.

Institution Name *

Institution Address *

Institution Email or Fax

Additional Notes

Notes

Please allow 3-5 business days for this request to be fulfilled.

For any questions, please contact Utica Academy of Science High School Guidance Department at 315-574-3000.

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