REQUEST FOR TRANSCRIPT
This form must be completed for each transcript request
Name: _________________________________________
Date: ___________________________
I am taking/have taken an MC class through the Early Placement
Program
Yes____ No____
I am a student in the WJ ACES Program
Yes____ No____
Counselors will complete secondary school reports and/or
recommendations once the Self-Evaluation and Resume in “Family
Connection” on Naviance have been completed
I am applying for Early Decision
I am a student in the WJ LEAD Program
Yes____ No____
Yes___ No___
Please print clearly
Yes___ No___
(One time only)
I have completed my FERPA
Yes___ No___
This is a Common Application School
Yes___ No___
I am using the Common App to apply
Yes___ No___
If yes, I have added this college to the CA list Yes___ No___
I have requested recommendations from these TWO teachers
____________________________ & __________________________
Name of college/university:
_________________________________________________________
Complete college address with zip code:
____________________________________________________________________
____________________________________________________________________
Check method of submission:
____________________________________________________________________
CA
____________________________________________________________________
Common
Application
Docufied
Electronically
but not CA
via Mail
US Postal Service
_______
______
_____
Application Due Date: ________________________
Everything to be sent to the college by WJ MUST be turned in
with this request
I am a student in the WJ APEX Program
Yes____ No____
I have turned in a Release of Records form
Counselor: _________________________
DO NOT WRITE IN THIS SPACE--FOR OFFICE USE ONLY
Fee Paid: Yes _____ No _____
Date submitted to counselor: __________
Transcript submission/mailing date: __________
Revised Jul 2014