H:\GuidInfo\Forms\Scholarship Transcript Request Form (2/2014)
Monroe-Woodbury High School
SCHOLARSHIP TRANSCRIPT REQUEST FORM
Please check:
Official Transcript:
Unofficial Transcript:
Resume:
Student’s Name: Date Received:
PLEASE NOTE: You may submit up to 3 scholarships per request form. Allow one week for
processing. Please provide an addressed envelope which should include 4 stamps (not affixed)
(see back) for each scholarship you are applying to.
Name of Scholarship
Recommendation Letters Needed:
Teacher(s):
Other:
Name of Scholarship
Recommendation Letters Needed:
Teacher(s):
Other:
Name of Scholarship
Recommendation Letters Needed:
Teacher(s)
:
Other:
Other material to be included:
I approve of my transcript being mailed to the address indicated on the attached addressed
envelope. I waive my right to access scholarship application materials and understand that it will
take a minimum of one full week to process this request.
Deadline to Guidance:
Deadline to Committee:
Student’s Signature:
For Official Use Only:
Date Received:
Completed By:
Date Completed:
{Please see reverse}
H:\GuidInfo\Forms\Scholarship Transcript Request Form (2/2014)
1. Please provide one 9 X 12 envelope addressed to each scholarship (see addressing the envelope on back).
2. Supply 4 stamps (paper clipped) to each envelope. DO NOT affix the stamps to the envelope.
Monroe-Woodbury High School
155 Dunderberg Road
Central Valley, New York 10917
Scholarship Committee Name
Scholarship Contact Person (if applicable)
Street Address
City, State, Zip Code
Make sure the address is correct, neat and legible.
Errors/illegible addresses will delay your transcript.
Please be sure to position the address as illustrated in the center!