Lansdale Catholic High School

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Graduates Only
Release of Academic Records

Please complete the form below to authorize Lansdale Catholic High School to release your academic records. There is a $5.00 charge per academic transcript release request.

Questions regarding transcript requests may be directed to Mrs. Regina Adams in the Guidance Office at (215) 362-6160 ext. 1380 or at radams@lansdalecatholic.com.

Qty

Description

Amount

Total

Transcript Request

$5.00

Total: $5.00

REQUESTER INFORMATION

I authorize Lansdale Catholic High School to release my academic records.

First Name: *

Last Name: *

Maiden Name
(if applicable):

Graduation Year: *

Please forward
transcript to: *

(Name of school, scholarship organization, company, etc)

Attention:

Address 1: *

Address 2:

City: *

State: *

Zip: *

Country: *

Email Address:

(Email address for school, scholarship organization, company, etc)

Payer Information

Transcripts may only be purchased by the Student or by the Parent or Legal Guardian.

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone: *

Email: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *