Independence Transcript Request Form by qoe36584

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									               Independence Transcript Request Form
     College Entrance Examination Board (C.E.E.B.) Code 340-673

             Please allow 10 school days to process all requests


Student Name ____________________________                  ID #__________
                      (Please Print)

Date Rec’d _____________         Date Request Completed ___________

Counselor ___________________ / _________________________
             (Print Counselor’s Name)           (Counselor’s Signature)

SAT and ACT scores are not printed on transcripts. It is the student’s
responsibility to send scores directly to the college or university. Refer to
www.collegeboard.com or www.actstudent.org for instructions.
The cost of printing, certifying and mailing each transcript is $3.00. A
Release of Information Form must be on file in order to process transcript
request.



Transcript Request Check List

_____ Official Transcript Only

_____ Counselor Letter of Recommendation

_____ Counselor / Secondary Report


Transcript To Be Sent To:
Please provide complete mailing address for the
college/university/scholarship requesting a transcript:




It is the student’s responsibility to mail all applications and application
fees directly to the college or university.

Application’s Deadline Date: ________________________________

								
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