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Leilehua High School 1515 California Avenue Wahiawa HI 96786 808. 305. 3101 Transcript Request Circle one of the following Present Grade/Year Graduated/Year Withdrew Date of Birth // PRINT LEGAL LAST NAME FIRST MI MAIDEN if different from legal last CURRENT ADDRESS CITY STATE ZIP HOME/CELL PHONE Requesting my OFFICIAL Transcript Quantity An OFFICIAL transcript will only be mailed to appropriate institution employer school etc Transcript must include check all that apply All test scores SAT/ACT Grades through the first semester of my senior year applies to current students only If mailing please provide EXACT address where transcript s should be sent. Use back if sending to multiple recipients Do not mail transcript. Check what is desired* Name Address Please check for accuracy Pick up personally on // date Request for print authorized person s name Regular Processing Fee - 2. 00 per transcript to pick up on // Expedite/Rush Processing Fee - 3. 00 per transcript Allow 5 working days to leave our office Same day processing Current students no charge for first 2 requests Requests received by 3pm will be sent to the Post Office by the next business day Cash money order or cashier s check only. Personal checks are not accepted* Student s Signature Date Signature must be the requestor of the above transcript Parent/Guardian must sign below if student is under the age of 18 years old. FOR OFFICE USE ONLY 1ST REQUEST 2ND REQUEST DATE RECEIVED DATE MAILED PROCESSED BY RECEIVED BY AMOUNT PAID MO / CC / CASH. Use back if sending to multiple recipients Do not mail transcript. Check what is desired* Name Address Please check for accuracy Pick up personally on // date Request for print authorized person s name Regular Processing Fee - 2. 00 per transcript to pick up on // Expedite/Rush Processing Fee - 3. 00 per transcript Allow 5 working days to leave our office Same day processing Current students no charge for first 2 requests Requests received by 3pm will be sent to the Post Office by the next business day Cash money order or cashier s check only. 00 per transcript to pick up on // Expedite/Rush Processing Fee - 3. 00 per transcript Allow 5 working days to leave our office Same day processing Current students no charge for first 2 requests Requests received by 3pm will be sent to the Post Office by the next business day Cash money order or cashier s check only. Personal checks are not accepted* Student s Signature Date Signature must be the requestor of the above transcript Parent/Guardian must sign below if student is under the age of 18 years old. Personal checks are not accepted* Student s Signature Date Signature must be the requestor of the above transcript Parent/Guardian must sign below if student is under the age of 18 years old. FOR OFFICE USE ONLY 1ST REQUEST 2ND REQUEST DATE RECEIVED DATE MAILED PROCESSED BY RECEIVED BY AMOUNT PAID MO / CC / CASH. Use back if sending to multiple recipients Do not mail transcript. Check what is desired* Name Address Please check for accuracy Pick up personally on // date Request for print authorized person s name Regular Processing Fee - 2. 00 per transcript to pick up on // Expedite/Rush Processing Fee - 3. 00 per transcript Allow 5 working days to leave our office Same day processing Current students no charge for first 2 requests Requests received by 3pm will be sent to the Post Office by the next business day Cash money order or cashier s check only. Personal checks are not accepted* Student s Signature Date Signature must be the requestor of the above transcript Parent/Guardian must sign below if student is under the age of 18 years old.

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