0% found this document useful (0 votes)
2 views2 pages

Transcript Request Form 3.23

The document is an authorization form for former students of Harford County Public Schools to request the release of their high school transcripts. It includes sections for personal information, recipient details, and special instructions, as well as a notification about the privacy of the records. The form must be printed, signed, and submitted to the appropriate school office for processing.

Uploaded by

dwinkler2
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
2 views2 pages

Transcript Request Form 3.23

The document is an authorization form for former students of Harford County Public Schools to request the release of their high school transcripts. It includes sections for personal information, recipient details, and special instructions, as well as a notification about the privacy of the records. The form must be printed, signed, and submitted to the appropriate school office for processing.

Uploaded by

dwinkler2
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Harford County Public Schools

AUTHORIZATION TO RELEASE HIGH SCHOOL TRANSCRIPT (Former Student)

Demographic Information:
Name When Enrolled in HCPS: Last______________________________ First_____________________________ MI________
Current Name (if different): Last______________________________ First_____________________________ MI________

YOUR Current Address: ________________________________________________________________

City: State: __ ZIP Code: _____

Date of Birth: / / Phone: ______________________


Email: __________________________________

Your last HCPS School of Attendance: ______________________________________________________________

Month/ Year of Graduation: _______________ OR Year of Withdrawal: (non-graduate) _________________

Where would you like your transcript sent? (Please use “special instructions” area for additional requests.)

Organization: __________________________________________________________ Attention: _________________________


Address: ______________________________________________________________________

City: State: _ _ ZIP Code: ______

Phone: ______________________ Fax: ________________ Email: _____________________

Email: __________________________________

Please indicate special instructions:

Authorization Notification

As the individual about whom this information is being requested, I hereby authorize the Office of School Counseling of the Harford County Public
Schools system to release information concerning my records. I understand that the recipient of the records(s) will use said document(s) for legitimate
interests only and that the information contained therein shall not be further transferred or communicated to any other party or agency without my
expressed written consent except under authority of Public Law 93-380, Educational Rights and Privacy Act.

REQUIRED Signature: Date: / /_____

Note: A third party may have requested your transcript be issued to them with the envelope seal unbroken.
Opening the envelope will render the transcript invalid or unofficial. Please order two transcripts if you
need a copy for personal use.

INSTRUCTIONS:
1. Print, complete, and SIGN this request form. Note: Typed signatures are not acceptable.
2. EMAIL or MAIL completed request to your high school.
3. Please allow 10 - 14 business days for processing.

Rev. 03/2023
SCHOOL ADDRESS MAIN OFFICE SCHOOL COUNSELING OFFICE
PHONE & FAX NUMBERS
Aberdeen High 410-273-5500 410-273-5585
251 Paradise Road Fax – 410-273-5587
Aberdeen, MD 21001-2399

Alternative Education – CEO 410-273-5594 410-273-5594


Swan Creek Fax- 410-273-5592
253 Paradise Road
Aberdeen, MD 21001-2492

Bel Air High 410-638-4600 410-638-4606


100 Heighe Street Fax – 410-638-7953
Bel Air, MD 21014-4196

C. Milton Wright High 410-638-4110 410-638-4270


1301 N. Fountain Green Rd Fax – 410-638-4612
Bel Air, MD 21015-2599

Edgewood High 410-612-1500 410-612-2071


2415 Willoughby Beach Road Fax – 410-612-1585
Edgewood, MD 21040-3496

Fallston High 410-638-4120 410-638-3542


2301 Carrs Mill Road Fax – 410-638-4125
Fallston, MD 21047-1899

Harford Technical High 410-638-3804 410-638-3884


200 Thomas Run Road Fax – 410-638-3820
Bel Air, MD 21015-1699

Havre de Grace High 410-939-6600 410-939-6603


700 Congress Avenue Fax – 410-939-6667
Havre de Grace MD 21078

Joppatowne High 410-612-1510 410-612-1510


555 Joppa Farm Road Fax - 410-612-1528
Joppa, MD 21085-4698

North Harford High 410-638-3650 410-638-3650


211 Pylesville Road Fax – 410-638-3632
Pylesville, MD 21132-1398

Patterson Mill Middle/High 410-638-4640 410-638-4633


85 Patterson Mill Road FAX- 410-638-4634
Bel Air, Maryland 21014

Note: If you wish to email your completed form, please contact the School Counseling office for the
email address of the current administrative support technician.

Rev. 03/2023

You might also like