Education Verification Request | Adams 12 Five Star Schools Transcripts and Records Requests

This is an official request for a copy of a student record. The information contained in this request should be considered private. Please complete all information in full and then finalize the order process by clicking 'Proceed to Check Out'. The information required on this page is necessary to verify and protect the school record from being accessed by unauthorized individuals. Please be sure to upload a signed authorization complete with the printed name of the signer.

You will receive emails from scribOnline@scribsoft.com to notify you of the status of your order. It is important you read those emails carefully as additional information may be required to process your request. We may respond to this request by email. Status can be checked via the 'Order Tracker'.

Once the order has been submitted and payment received, you will be directed to a confirmation page which contains the link to the Order Tracker. You will also receive a link to the Order Tracker via email from scribonline@scribsoft.com. To access the Order Tracker, you will enter your email address, order number and password.

All Verification of Graduation will be EMAILED and to include the date of graduation or dates of enrollment if not graduated.

Corporate Requestor Information:

Corporate Name: ^(legal)

Federal Tax ID:

Business Client Name:

Internal Tracking ID:

Contact Name:

Corporate Address:

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

Corporate Telephone: ^{(###-###-####)}

^Primary:

^Cell:

Updates via Text Message?

Yes No

Email:

^Address:

^Confirm:

Student's Name While Attending School:

Last Name: ^{(in school)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Last 4 SSN:

Last 4 SSN: ^(confirm)

Student ID:

Information Related To Student's Birth:

Date of Birth:

Current Age:

Student's Last Adams School of Attendance:

Name of School :

Last Year Enrolled:

Did they graduate?

Yes No

Student Summer School:

Attend Summer School?

Yes No

When: ^{(last year)}

Student Current Name:

Last Name: ^{(official id)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Student's Current Residence Address: ^{(this may be different than the mailing address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Student's Current Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

Documents Will Be Delivered To: ^{please enter the delivery addresses}

	Name	Attention	Addr 1	Addr 2	City	State	Zip	Country	# of Copies

I would like express shipping!

Special Instructions :

Reason(s) for Request of Student Record:

Employment

Education

Identification

Immigration

Other (Indicate reason for request in the Special Instructions above)

Select The Information Type(s) Requested:

Verification of Graduation

( $15.00 ea. + $15.00 copy )

Electronic Official HSTranscript

( $15.00 ea. + $15.00 copy )

Mail Official HS Transcript

( $15.00 ea. + $15.00 copy )

Total Fee:

AUTHORIZATION NOTIFICATION:

I hereby certify and verify that my corporation has expressed written consent to release information from the former student of Adams 12 Five Star Schools for which this request is made. I understand that the recipient of the record(s) will use said documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other part or agency without the expressed written consent of the former student except under authority of Public Law 93-380, Educational Rights and Privacy Act. By clicking 'Proceed to Checkout', I certify this information as complete and accurate.

I have enclosed the correct fees and understand that they are nonrefundable. I understand that an incomplete form will not be processed and will be considered closed after expiration of the 30 day notification window. I declare under penalty of perjury that the foregoing is true and correct.

Coupon Code:

Your Initials:

Pay by Money Order

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Online Corporate Information Request Step 1, Please Enter All Information