Records Request
Please allow 3-5 business days to process. A processing fee of $0.25 per record may be applied.
Sign in to Google to save your progress. Learn more
Email *
Student name (include MAIDEN name if applicable): *
Date of Birth *
Phone number: *
Did the student graduate *
If so, what year:
Last Union-Endicott school the student attended: *
Are you the student named above? *
If you are not the student, what is your name AND relationship to the student?
What record is being requested? *
Delivery Method: *
Delivery specifics: please provide the business or government agency/college NAME that the record should be addressed with.
Delivery specifics: please provide the fax number; or email address; or street address of the business or government agency/college.
NOTE: For duplicate GED certificate/ and transcripts contact the N.Y State HSE Office at: 518-474-5906 and/or Email:
By submitting this form, you agree the above information is accurate to your knowledge and that you have the legal right to request these records.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Union Endicott Central Schools. Report Abuse