Pottsgrove High School Transcript Release

Pottsgrove High School

Transcript Release

This form can be opened in Microsoft Word and filled out electronically. Student signature is required. Parent signature is required if student is under 18.

Name (If married, please list maiden name):     

Year of Graduation:      Date of Birth:      

PAST GRADUATES ONLY: Please list the name and address of where you would like your transcript sent.

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CURRENT STUDENTS ONLY: Please fill out the following information.

Please check the correct box for how your transcript should be delivered:

If you are requesting your transcripts be mailed, please provide a stamp for each mailed transcript.

Transcripts should be sent to the following institutions: Application Type Application Type

		Office Use Only	RL=Rolling RD=Regular ED=Early Decision EA=Early Action	College Deadline 1/15/13	Common App	Electronic	US Mail
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By signing below I authorize Pottsgrove High School send my academic record including all grades, GPA, and standardized test scores to the above institutions.
Student Signature: ______________________________________________________________________________________________________

Parent Signature: _______________________________________________________________________________________________________

Office Use Only – Date Submitted to Guidance: ___________________________________________________________________