VCSC High School Transcript/Immunization Request Form

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Email *

Last Name *

Middle Name *

First Name *

Maiden Name (if applicable)

Date of Birth *

YYYY

Phone *

Fax Number (if applicable)

Mailing Address *

Graduating School or last school attended in VIGO CO: *

Year Graduated or Year Withdrawn *

What records do you need to obtain? *

Transcript

Immunizations

Both transcript and immunizations

How would you like to receive your transcript/immunization copy? *

Email - Make sure your email is correct! Please check SPAM folder if you request it to be emailed.

Mail

Fax

Pick Up at VCSC - You will be contacted when it is ready for pick up - 501 W Olive St

Signature *

Date *

YYYY

Submit

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