LOUDOUN COUNTY PUBLIC SCHOOLS
REQUEST FOR TRANSCRIPTS TO BE SENT TO OTHER SCHOOLS, ORGANIZATIONS OR
SCHOLARSHIP SPONSORS
I hereby request that a transcript of the scholastic records of
Student’s Name
be sent to the following schools, organizations or scholarship sponsors.
School, Organization, or
Scholarship Sponsor
Address
Deadline
Date of
Request
Date
Processed
Scores on the SAT I and II, Advanced Placement Exams, and ACT should be sent directly from the
College Board or ACT at the request of the student.
I understand that I have the right to obtain a copy of these records upon payment of the cost of
reproduction and that I have the right to a hearing to challenge the content or accuracy of these
records by contacting the school.
Student’s Name — PRINT or TYPE
Student’s Signature
Parent’s Signature
RT-10
Rev 10-26-05