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Request for High School Transcript
Please complete all sections of this request form. Billing for current students will be at the end of the school year. Please make
payments at the main office using cash only Esteemed alumni--FREE. Allow 1-2 weeks for processing of transcripts.
Send this form by mail, fax, or email. Mail: 980 Lahainaluna Road, Lahaina, HI 96761
Fax: 808-662-3978/Email: 414transcripts@lahaina.k12.hi.us.
STUDENT INFORMATION
Last Name
First Name
Middle Initial(s)
Previous Name (if applicable)
Date of Birth
Email Address (print clearly)
Telephone
Choose one
current student former student
Graduation Year
Total number of transcripts ($1 per)
one more (use the back)
FIRST TRANSCRIPT INFORMATION
Institution/Business/Organization
Attn Counselor/Office/Person
Email
Address (Number, Street Name)
Address (City, State, Zip Code)
Fax number
DEADLINE
OFFICIAL transcript certified (stamped, signed, & sealed) by Registrar
Choose transcript delivery via Mail Pick Up
current semester
8
th
semester *after graduation; do not mix this
request with "current semester" requests
UNOFFICIAL transcript not certified (not signed) by Registrar
Choose transcript delivery via Mail Pick Up Fax
Upload to student; we will not upload to organization
Include test scores No Yes, ACT/SAT--Student will provide to be added to envelope Yes, SBA (Smarter Balanced Assessment)
AUTHORIZATION FOR RELEASE OF RECORDS
I authorize Lahainaluna High School to release academic transcripts to the agency/person(s) listed above.
Student signature (parent/guardian if under 18)
Date
Print Parent/Guardian Name Parent/Guardian Signature
Date
The following person may pick up the transcript on my behalf
For office use only Received For office use only Processed & Recorded For office use only Sent & Notified
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Addresses for Multiple Transcript Requests Please provide the complete information for each transcript requested.
#2 TRANSCRIPT
#3 TRANSCRIPT
OFFICIAL transcript certified (stamped, signed, & sealed) by Registrar
Choose transcript delivery via Mail Pick Up
OFFICIAL transcript certified (stamped, signed, & sealed) by Registrar
Choose transcript delivery via Mail Pick Up
Unofficial transcript not certified by Registrar
Choose transcript delivery via Mail Pick Up Fax
Upload to student; we will not upload to organization
Unofficial transcript not certified by Registrar
Choose transcript delivery via Mail Pick Up Fax
Upload to student; we will not upload to organization
Institution/Business/Organization
Institution/Business/Organization
Attn Counselor/Office/Person
Attn Counselor/Office/Person
Address (Number, Street Name)
Address (Number, Street Name)
Address (City, State, Zip Code)
Address (City, State, Zip Code)
Email/Fax number
Email/Fax number
DEADLINE DEADLINE
Check front side for specific information
Current semester 8
th
semester
Check front side for specific information
Current semester 8
th
semester
Check front side for specific information
Include test scores No Yes, ACT/SAT Yes, SBA
Check front side for specific information
Include test scores No Yes, ACT/SAT Yes, SBA
#4 TRANSCRIPT
#5 TRANSCRIPT
OFFICIAL transcript certified (stamped, signed, & sealed) by Registrar
Choose transcript delivery via Mail Pick Up
OFFICIAL transcript certified (stamped, signed, & sealed) by Registrar
Choose transcript delivery via Mail Pick Up
Unofficial transcript not certified by Registrar
Choose transcript delivery via Mail Pick Up Fax
Upload to student; we will not upload to organization
Unofficial transcript not certified by Registrar
Choose transcript delivery via Mail Pick Up Fax
Upload to student; we will not upload to organization
Institution/Business/Organization
Institution/Business/Organization
Attn Counselor/Office/Person
Attn Counselor/Office/Person
Address (Number, Street Name)
Address (Number, Street Name)
Address (City, State, Zip Code)
Address (City, State, Zip Code)
Email/Fax number
Email/Fax number
DEADLINE DEADLINE
Check front side for specific information
Current semester 8
th
semester
Check front side for specific information
Current semester 8
th
semester
Check front side for specific information
Include test scores No Yes, ACT/SAT Yes, SBA
Check front side for specific information
Include test scores No Yes, ACT/SAT Yes, SBA