Retention: CY +1 year (CY = current year)
REQUEST FOR STUDENT RECORD OR TRANSCRIPT
( (in accordance with the Education Act & Regulations)
Please mail this form to Grand Erie Learning Alternatives, 365 Rawdon Street, Brantford, ON N3S 6J3
Last Grand Erie School Attended
Year of Graduation or Departure
Document Requested (please check below) $24.00 fee if departure from school 10+ years ago. ALL applicants must
submit a copy of their photo I.D. If paying by certified cheque or money order, they may be mailed. If paying by cash, debit
or credit card, please make an appointment, 519-753-6079. For e-transfers, please send to firstname.lastname@example.org.
Secondary School Transcript
Distribution Information (48-72 hours are required for processing from date receiving this form)
Pick Up (if not by applicant, indicate name below)
I authorize release of the requested document(s) to:
Send to above address OR as below:
Authorization (to be completed by Applicant)
I authorize Grand Erie District School Board to release the requested document(s) as specified in the Distribution Information section.
Personal information is collected under the authority of the Education Act R.S.O. 1990 and is used for processing this request.
☐ Cash ☐ Chq/MO ☐ DR ☐ CC ☐ NC
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