Editing previous response:

Please fix the highlighted areas below before submitting.

Transcript / Student Record Request

Name at the time of Graduation:*

Answer required for "Name at the time of Graduation:"

Current name:*

Answer required for "Current name:"

Birth Date*

Answer required for "Birth Date"

Email Address*

Answer required for "Email Address"

Phone Number*

Answer required for "Phone Number"

Last year attending this school*

Answer required for "Last year attending this school"

Send Transcript Via:*

Answer required for "Send Transcript Via:"

Fax

Mail

Pick up at administration office

OFFICIAL TRANSCRIPST MUST BE MAILED DIRECTLY TO THE AGENCY OR SCHOOL

Agency/School or Self*

Answer required for "Agency/School or Self"

Street Address

Answer required for "Street Address"

City

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

CONSENT FOR RELEASE OF INFORMATION

I hereby authorize Family Partnership Charter School to Release and/or send my educational information to the agency/school/self at the address listed above.*

Signature Required

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"