Transcript Request Form
Wyoming Valley West School District
Please fill in the required fields below. Allow 5-7 business days for the request to be processed. Please contact our High School at 570-779-5361 with any questions.
Last Name:
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First Name:
*
Maiden Name:
Date of Birth
*
mm/dd/yyyy
Contact Email Address
*
This should be a personal email address should we need to contact you.
Graduation Year:
*
Did you graduate?
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Did you graduate?
*
Yes
No
Dates of Attendance
Location to send Transcript (Pick one):
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Location to send Transcript (Pick one):
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Pick up
Mail
Email
Fax
Address if Mailing:
Transcript Email Address:
Email address to send transcripts.
Fax: (Please enter fax number):
Comments:
In accordance with the Federal Privacy Rights of parents and students, the following consent is necessary in order for Wyoming Valley West School District to release student records. I authorize the release of my official transcripts to the mentioned recipients.
*
I agree