Transcript Request

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	Carl Junction High School

	Transcript Request – Former Student

	Complete the form below and push "Done" to request a Carl Junction High School transcript. For questions, contact Heather Whelan at 417-649-7081 x2611 or hwhelan@cj.k12.mo.us. Please note that official transcripts are sent only to a school or employer. If you request a transcript for your personal records, it will be an unofficial version.

1.	Current Name:*

2.	Maiden name or other name used while attending high school:

Current Address:*

Street Address
City, State
Zip

4.	Phone number including area code:*

5.	Current email address:*

6.	Date of birth:*
	mm/dd/yyyy

7.	Last 4 of Social Security #:*

8.	Last year of attendance:*

9.	Did you graduate?*
	Did you graduate?* YesNo

10.	Does this need to be an official transcript for school or employment?* Official transcripts are sent only to a school or employer. If you request a transcript for your personal records, it will be an unofficial version.
	Does this need to be an official transcript for school or employment?* Official transcripts are sent only to a school or employer. If you request a transcript for your personal records, it will be an unofficial version. YesNo

11.	Include ACT scores?*
	Include ACT scores?* YesNo

12.	Name of the school or employer:

Where & how do you want the transcript sent?
Transcripts will be sent electronically through the National Student Clearinghouse if the receiving school participates.

Attn:
Email:
Fax:
Address:
City, State
Zip

14.	Unofficial copy picked up by former student:
	Unofficial copy picked up by former student: YesNo

15.	Electronic Signature:* By typing my name below, I am affirming that I am the former Carl Junction High School student listed above and I am authorizing my transcript to be sent or made available as requested.

Done