Elementary Transcript Release Form

Student Information

First Name(*)

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Middle Name

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Last Name(*)

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Preferred Name(*)

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Applying For(*)

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

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Present School/Program Information

Present School

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Principal/Director

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Present School Address

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City

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State

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ZIP

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Program Phone

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Program Fax

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Program Email

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Please upload the following

• Current School Transcript
• Cumulative Record
• All Standardized Testing
• Health Records

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I hereby certify that I am the parent/guardian of the above named student and give my permission for his school information to be released. I understand that teacher recommendations are confidential and will not become part of the student’s permanent academic record nor will it be shared with parents, guardians or students. I also grant permission for Presbyterian Day School staff to observe my son in his current classroom if deemed necessary. Invalid Input

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