Student Information
- Name:
- Date of Birth:
- Student ID Number (if known):
- Last High School Attended:
- Graduation Date (if known):
Contact Information
- Address:
- City:
- State:
- Zip Code:
- Phone Number:
- Email Address:
Transcript Request Details
- Number of Transcripts Requested:
- Purpose of Transcript Request (e.g., college application, scholarship application, employment application):
- Recipient Name and Address (if sending transcripts directly to a third party):
Authorization
I hereby authorize the release of my academic records, including transcripts, from the Chicago Public Schools to the recipient(s) listed above. I understand that my request may take up to 10 business days to process.
Student Signature:
Date:
Please submit this form and a valid photo ID to your former high school's student records office. Transcripts will only be released with the student's written consent or upon presentation of a valid subpoena.