HAYFIELD SECONDARY SCHOOL
2021-2022 TRANSCRIPT REQUEST FORM
HHS CEEB Code: 470028
_____________________________________________________ ____________________ _________________________
Student Name (print neatly: Last, First, Middle Initial) Student Date of Birth Student ID #
_______
______ ______________________________ ____________________ _________________________
Graduation Year Student FCPS Email Address Student Phone # Counselor Name
Per FCPS Form IS-111, your signature on that form authorized Hayfield Secondary School to release the above-named student’s official records to the colleges or
scholarships listed on this form. In addition, you indicated whether or not you waived your right to access letters of recommendations written by FCPS employees.
_______
_______________________________ __________ ______________________________________ __________
Student Signature Date Parent Signature (If student is under 18) Date
1. Need a counselor recommendation letter? You MUST submit a Student Information Form https://hayfieldss.fcps.edu/node/2183 *AND* you must as
k your
counselor via an in person meeting or email to write a letter AT LEAST ONE MONTH before your college deadline.
2. Need a teacher recommendation letter? You are responsible for requesting AND submitting teacher recommendations. Teacher letters are NOT sent with your
official transcript packet from Hayfield Secondary School.
3. Hayfield Secondary School does not send SAT, or ACT scores to colleges. You must request them online via College Board (www.collegeboard.com) or
ACT (www.act.org).
4. Check the items below before you give this form to your counselor:
Include the IS-111 form (FCPS Consent for Release of Student Records) the first time you turn in the Transcript Request form. Please see Senior
Packet or https://hayfieldss.fcps.edu/node/2183 for form.
If you need a counselor letter of recommendation and have not already requested one, please be sure to complete the Student Information Form prior
to submitting this Transcript Request form.
Include $5.00 for each transcript. The first three are free of charge. Payment is accepted via My School Bucks under the “Transcript” tab. The transcript
fee is waived for students who have been approved for free or reduced lunch. Please contact your counselor for College Application Fee Waiver forms.
Yo
u must allow AT LEAST 4 weeks, not including school holidays for processing and sending transcripts. We cannot guarantee transcript delivery by
your deadlines for forms submitted late.
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