Dr. John Deasy
LOS ANGELES UNIFIED SCHOOL DISTRICT Superintendent of Schools
JOHN H. FRANCIS POLYTECHNIC HIGH SCHOOL Linda Del Cueto
12431 ROSCOE BLVD, SUN VALLEY, CA 91352 ESC North Superintendent
PHONE: (818) 394-3600 FAX: (818) 771-0452 Ari Bennett
A LEARN SCHOOL Principal
OFFICIAL TRANSCRIPT REQUEST FORM
To order transcripts from Polytechnic HS: Print and mail this completed form to the above address, Attn: Records OR
FAX the form to 818 -767-7949 OR visit the Counseling Office between the hours of 1:30 to 4:00 pm.
Please include a copy of proper ID, (Drivers License, School ID, etc) with fax or letter, or have valid ID if you come
Please Note: If you attended Poly PRIOR to June 2002 your records have been sent to Student Records for
digitizing. Follow directions as above or email us at address below and we will provide you with your record
number, free of charge, so you can order your records directly from them.
If you need more information please Email our Credit Clerk at: email@example.com
Last Name (As used when at Poly) First Middle Date of Birth (mm/dd/yyyy)
Year Graduated or Last Attended Telephone Number
Current Address Number and Street City State Zip Code
Send Transcript to: (If to a different address than above)
Name of Institution: _____________________________________________ Attention: ______________________________
Address: ___________________________________________________City __________________ State _____ Zip _______
OR to FAX NUMBER: ( ) -
Please Check type of Records required:
Official High School Transcript _______ Proof Of Graduation Letter __________ Fee for either: $10.00
NO PERSONAL CHECKS ACCEPTED. FEE PAYABLE BY CASH OR BY MONEY ORDER MADE OUT TO POLY HS.
If someone else other than yourself will pick up you transcripts, with proper ID., from our office please fill the following:
Name: ___________________________________________________________ Relationship: _________________________
The signature below verifies that I have completed all sections accurately and enclosed the correct fee. I understand that fees are
Non Refundable, and that application will not be processed if it is incomplete.
SECTION FOR OFFICE USE ONLY.
We no longer have your records at Poly, they have been sent to the LAUSD Student Records for digitizing.
You can request your records directly from them at:
Student Records Center
2151 n. Soto St Los Angeles, CA 90032
Phone: (323) 224 5950 or on the Web:www.transcripts.lausd.net
YOUR RECORD NUMBER (TO ORDER FROM STUDENT RECORDS CENTER): P
Duplicate diplomas can be ordered from Student Records. Call them directly for details.