RECORDS REQUEST FORM
Please complete the form below and it will be submitted to the Counseling Office.
Should you require additional assistance please call 330-877-4285 and ask for Tanya Reynolds or Karen Davidson.
Email address *
Name *
Your answer
Maiden Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Graduation Year *
Your answer
If you did not graduate what year did you withdraw from Lake High School
Your answer
Address *
Your answer
Phone Number *
Your answer
Records Needed *
Required
Preferred delivery method for your transcript and/or records request *
Where to send records to(choose all that apply): *
Required
Based on the selection above, please provide the name, address, email or fax number. If multiple selected above, please label each(Ex. If University and email selected above it should look like this: The Ohio State University-281 W. Lane Ave. Columbus, OH 43210, and please also email to johnsmith@gmail.com). *
Your answer
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