Transcript Request Form

Date of Requestrequired

Must contain a date in MM/DD/YYYY format

Name of RequestorrequiredName of person requesting the transcript

First Name

Last Name

Name of person requesting the transcript

Requestor Email Addressrequired

Requestor Phone Numberrequired

Requestor Mailing Address - Street, City, State, and Zip Coderequired

Name of AttendeerequiredName of person on the requested transcript

First Name

Last Name

Name of person on the requested transcript

Attendee Date of Birthrequired

Must contain a date in MM/DD/YYYY format

Attendee ID Number (if known)

Last PASD School Attendedrequired

Last Year Attendedrequired

Are you a graduate?required

Yes

No

What year did you graduate?required

How would you like to receive your transcript? (multiple options can be selected)required

Officially (in a sealed envelope) - Mailed

Officially (in a sealed envelope) - In-person pick-up

Officially - sent to 3rd party (e.g. college, employer)

Unofficially - via email

Unofficially - In-person pick-up

Would you like this sent to a 3rd party? (e.g. college, employer)

Yes

No

Please provide the name of the 3rd party and its mailing address or email address:

Form Acceptance and Submission

By selecting the "I Accept" checkbox, you are signing this agreement electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form.

Accept?required

I Accept

I Do Not Accept

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