Adult High School Transcript and Diploma Request

Adult High School Transcript and/or Diploma Request Form

Note: All transcript and diploma fees are non-refundable and non-transferable

All fields with an asterisk (*) must be completed.



*	First Name:
	Middle Name:
*	Last Name:
*	Street:
*	Municipality:
*	Province:
*	Postal Code:
*	Country:
*	Date of Birth	Example: yyyy-mm-dd
*	Telephone Number:
*	Email:

*	Check Appropriate Boxes	Adult High School Transcript (Fee $5) Adult High School Diploma (Fee $10)
*	Total:

Complete this section only if you want these results sent to someone other than yourself
	Name of Person or Institution:
	Postal Code:
	Street:
	Municipality:
	Province:
	Country:
	Fax:
	Special Instructions