TRANSCRIPT REQUEST FORM

NAME: (LAST) (MAIDEN) (FIRST) (MIDDLE)

Birthdate: Year Graduated: Phone #: Residence Address: Send Transcript To: (ATTN: ) (College, University, Scholarship Organization, Business, Etc.)

Address:

Transcript is to be sent: Cost of Transcript: a. directly to above address. $1 per transcript request (all requests need separate form) b. to counselor (name of counselor) **Currently enrolled Moanalua High School Students: first 2 c. to me. Or picked up personally. transcripts are free as long as student provides LEGAL sized (Transcript will be UNOFFICIAL.) stamped envelope. All following requests are $1.

Transcript must include: Send Transcript request to a. 6 sem. (end of junior year) Moanalua High School, Attn: Registrar b. 6 sem. & 1st quarter report card. 2825 Ala Ilima St, Honolulu HI 96818 c. 7 sem. (includes S1 sr. yr. Report card) **Please allow 5-7 business days to process all request** d. 8 sem. (end of senior year) For Office Use Only e. American College Test (ACT) scores (DOE administered only) Date transcript was made f. Honors Certificate(s) (e.g. Academic, CTE, STEM, Bilingual) Initials g. Others (specify): Date actually mailed Initials Student’s Signature Date Parent’s Signature (if under 18 yrs old) Date

*Request will not be processed until payment is received.* revised 05/2017

TRANSCRIPT REQUEST FORM

NAME: (LAST) (MAIDEN) (FIRST) (MIDDLE)

Birthdate: Year Graduated: Phone #: Residence Address: Send Transcript To: (ATTN: ) (College, University, Scholarship Organization, Business, Etc.)

Address:

Transcript is to be sent: Cost of Transcript: a. directly to above address. $1 per transcript request (all requests need separate form) b. to counselor (name of counselor) **Currently enrolled Moanalua High School Students: first 2 c. to me. Or picked up personally. transcripts are free as long as student provides LEGAL sized (Transcript will be UNOFFICIAL.) stamped envelope. All following requests are $1.

Transcript must include: Send Transcript request to a. 6 sem. (end of junior year) Moanalua High School, Attn: Registrar b. 6 sem. & 1st quarter report card. 2825 Ala Ilima St, Honolulu HI 96818 c. 7 sem. (includes S1 sr. yr. Report card) **Please allow 5-7 business days to process all request** d. 8 sem. (end of senior year) For Office Use Only e. American College Test (ACT) scores (DOE administered only) Date transcript was made f. Honors Certificate(s) (e.g. Academic, CTE, STEM, Bilingual) Initials g. Others (specify): Date actually mailed Initials Student’s Signature Date Parent’s Signature (if under 18 yrs old) Date

*Request will not be processed until payment is received.* revised 05/2017