Transcript Request Form

Please fill out this form and submit a signature page with payment to receive a transcript or health record.

Click here to download signature page.


Transcript Request

I hereby give consent for the SCH to release information about

Maiden Name if Applies .

Date of Birth: (MM/DD/YYYY)
Year of Grad:
School:
Misc:

(ex. dropped out, changed schools, etc.)

Reason:

Address:

(Applicant)

Phone:        
Email:        

SSN:
Last 4 Digits
(Student)

Requested by:
Relationship:
Date: (DD/MM/YYYY)

**Note: A signature page must be mailed to:

School City of Hammond, Central Files, 41 Williams Street, Hammond, IN 46320

Payment must be included with signature page.

Transcript: $5.00 Fee (Cash or Money Order)

Health Records: $1.00 Fee Per Page (Cash or Money Order)

(Money Order should be made out to: School City of Hammond)



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