Alumni Transcript Request |

This is a official request for offical student records which include transcript, enrollment history and attendance. Please complete all information in full.

All requests for records will be mailed to the address provided.

Status can be checked via the 'Order Tracker'.

Name While Attending School:

Last Name: ^{(in school)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Last 4 SSN:

Last 4 SSN: ^(confirm)

Student ID:

Information Related To Your Birth:

Date of Birth:

Current Age:

Birth City:

Birth State:

Birth Country:

Your Last Orange County School of Attendance:

Name of School :

Last Year Enrolled:

Did you graduate?

Yes No

Current Name / Requester Name:

Last Name: ^{(official id)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Current Residence Address: ^{(this may be different than the mailing address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Current Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

Telephone Number: ^{(###-###-####)}

^Primary:

^Cell:

Updates via Text Message?

Yes No

Driver's License: ^{(or other State Issued ID)}

^{ID Number:}

^{Issuing State:}

Email:

^Address:

^Confirm:

Special Instructions :

Documents Will Be Delivered To: ^{please enter the delivery addresses}

	Name	Attention	Addr 1	Addr 2	City	State	Zip	Country	# of Copies

Reason(s) for Request of Student Record:

Employment

College

Identification

Birth Certificate

Immigration

Other

Select The Information Type(s) Requested:

Current Students

( $0.00 ea. + $0.00 copy )

Former Students

( $1.00 ea. + $1.00 copy )

Total Fee:

AUTHORIZATION NOTIFICATION:

My initials below constitute an electronic signature and authorizes the Records Department of Fullerton Joint Union High School District to release information and / or my student record and confirms I have completed all sections accurately and truthfully, including information verifying my identity. I understand that the recipient of the record(s) will use the indicated documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other part or agency without my expressed written consent except under authority of Public Law 93-380, Educational Rights and Privacy Act.

I have enclosed the correct fees and understand that they are nonrefundable. I understand that an incomplete form will not be processed and will be considered closed after expiration of the 30 day notification window. I declare under penalty of perjury that the foregoing is true and correct.

I would like to donate $1.00 to the Fullerton's Love for Orange County Kids (FLOCK). FLOCK is a 501(c)3 non-profit organization whose mission is to end the cycle of homelessness for the children of Orange County by sponsoring local students to support sustainable housing and education. With all of the contributions going to current students in need, they aim to provide items such as food, clothing, school supplies, and college scholarships.

Please enter your e-Signature

Your Initials:

For security purposes, we logged your IP Address: 52.15.238.221, 162.158.79.6, 30.1.2.33

Coupon Code:

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