ATTENTION STUDENT
Use this form to request your official transcript from your high school.


High School Transcript Release Form 

DATE: 

TO:


(Insert name of high school) 

(Street address) 

(City, State, Zip Code) 

Dear Guidance Office: 
Please send OFFICIAL HIGH SCHOOL TRANSCRIPT for: 
Student: ____________________________________________________ 
Date of Birth: _______________________________________________ 
Date of Graduation: _________________________________________ 

Signature of student authorizing release 

Transcript should be sent to: 
ORANGE COUNTY COMMUNITY COLLEGE 
ADMISSIONS OFFICE 
115 South Street 
Middletown, NY 10940 

Thank you for your prompt attention to this matter.