CONARD HIGH SCHOOL

POST-GRADUATION REQUEST FOR TRANSCRIPT

-THERE IS A $2.00 FEE FOR EACH TRANSCRIPT REQUESTED-

Please provide us with the following information:

§         Date of Request: ____________________________________

§         Student Name:______________________________________

§         Maiden Name (If Married):______________________________

§         Social Security#:_____________________________________

§         Date of Birth:________________________________________

§         Year of :  (fill in year)  Graduation ____  Left Conard:________

§         Signature:___________________________________________

§         Phone number you can be reached at:_____________________

§         Check one: OFFICIAL  TRANSCRIPT     ______   

§                           UNOFFICIAL TRANSCRIPT ______

§         Names and addresses of schools you would like transcripts sent to:

    _____________________________________________________________

    _____________________________________________________________

    _____________________________________________________________

    _____________________________________________________________

    _____________________________________________________________

METHOD OF PAYMENT:  Cash, check or money order made payable to Conard High School.

Mail to:     Conard High School
               110 Beechwood Rd.
               West Hartford, CT  06107
               Attn: Mrs. Bella Glazer, Guidance Dept.