Transcript Request Form

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					                                                          Poolesville High School Transcript Request Form
          Type*                 Name of College            Address of College         Date my            Early        Early        Priority      Fee          Date
       ( , , )                                                                       Application       Decision       Action        (Yes,                 Electronically
     Please Circle and                                                                is Due to      (Yes, No)if      (Yes,          No)                  Processed or
    Indicate Y or N for                                                                College        yes make         No)                                   Mailed
            CA                                                                                         sure you
                                                                                                        see ED
                                                                                                     instructions
(     ,     ,     )                                                                                                                             Free
                 Y or N

(     ,     ,     )                                                                                                                             Free
                 Y or N

(     ,     ,     )                                                                                                                             Free
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N


     KEY
          tTot
           - Non-Common App school that accepts electronic submissions
           - College only accepts postal mail

         - Common App School – For CA schools you MUST indicate Y or N to let us know if you are using the Common App or not. If yes, you must match your CA account to
     Family Connections. If not, your packet will be mailed and you will NOT have the ability to track it electronically.
                                                          Poolesville High School Transcript Request Form
          Type*                 Name of College            Address of College         Date my            Early        Early        Priority      Fee          Date
       ( , , )                                                                       Application       Decision       Action        (Yes,                 Electronically
     Please Circle and                                                                is Due to      (Yes, No)if      (Yes,          No)                  Processed or
    Indicate Y or N for                                                                College        yes make         No)                                   Mailed
            CA                                                                                         sure you
                                                                                                        see ED
                                                                                                     instructions
(     ,     ,     )                                                                                                                             Free
                 Y or N

(     ,     ,     )                                                                                                                             Free
                 Y or N

(     ,     ,     )                                                                                                                             Free
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N

(     ,     ,     )                                                                                                                             $4.00
                 Y or N


     KEY
          tTot
           - Non-Common App school that accepts electronic submissions
           - College only accepts postal mail

         - Common App School – For CA schools you MUST indicate Y or N to let us know if you are using the Common App or not. If yes, you must match your CA account to
     Family Connections. If not, your packet will be mailed and you will NOT have the ability to track it electronically.

				
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