HAYFIELD SECONDARY SCHOOL STUDENT SERVICES DEPARTMENT
2015-2016 SENIOR TRANSCRIPT REQUEST FORM
“I hereby authorize Hayfield Secondary School to forward information from my official record to institutions of higher learning or prospective
employers as indicated below. Postage and any applicable fees are attached. I authorize electronic submission of student data in occasions
where paper copies are not accepted.”
__________________________
Student Name (print), ID #
_______________________
Student Signature
_____________________
Student Email
__________________________
Parent/Guardian Name (print)
_______________________
Parent/Guardian Signature
_____________________
Date
PROCEDURE:

Please complete this form, with signatures, and return it to your counselor. Submit application directly to college/university (online or mail).

Allow at least two weeks for letters of recommendation to be written, and for processing and mailing of transcripts. Lack of payment (if
applicable) and/or postage will delay processing. See chart for guideline of due dates.

The first three transcripts will be sent free of charge. Additional copies cost $5.00 per transcript. Please make checks payable to Hayfield
Secondary School. We will waive the fee when transcripts are requested for scholarship applications (must say “scholarship” somewhere in
address).

Please attach two first class letter stamps for each application.

Contact SAT (collegeboard.org) or ACT (actstudent.org) to have your scores sent directly to the college. Transcripts do not display scores.
CHECKLIST:
 Transcript Request Form, completed and signed. Both parent and student signatures required on initial request form only.
 Two first class letter stamps per mailing.
 $5.00 per transcript
 If you need a counselor recommendation:
o Student Information form
o Parent/guardian Information form (Brag Sheet)
o Student Activity Record or resume
 **PLEASE NOTE: Teacher recommendations must be sent by the teacher. Please submit a stamped, college addressed
envelope to your teacher for each recommendation requested.**
 Secondary School Report/Counselor Recommendation Form (student sign and complete student portion prior to submitting to counselor).
Request DUE to Counselor
October 16, 2015
October 30, 2015
November 16, 2015
December 1, 2015
December 4, 2015
December 18, 2015
January 15, 2016
1.
Application Deadline for
College/University
November 1, 2015
November 15, 2015
December 1, 2015
December 15, 2015
January 1, 2016
January 15, 2016
February 1, 2016
I have applied to ___________________________________________
College/university/scholarship
Address: _________________________________________________
_________________________________________________
_________________________________________________
Student, please check off necessary items:
Please send the following to this institution:
 Transcript/Profile
 Secondary School Report
 Counselor Letter of Recommendation
Attached:
 $5
 Fee waived (scholarship or free/reduced lunch)
 2 first class stamps
7th semester grades will automatically be mailed in mid February
Application Due Date: ______________
OFFICE USE ONLY:




Early Decision
Early Action
Regular
Rolling
E-docs: N_________
Y_________
Conf_____________
Date received by counselor:
_______________________
Date received in Records
Office: __________________
Date Sent: _____________
Initials: ________________
2.
I have applied to ___________________________________________
College/university/scholarship
Address: _________________________________________________
_________________________________________________
_________________________________________________
Student, please check off necessary items:
Please send the following to this institution:
 Transcript/Profile
 Secondary School Report
 Counselor Letter of Recommendation
Application Due Date: ______________
OFFICE USE ONLY:




Early Decision
Early Action
Regular
Rolling
E-docs: N_________
Y_________
Conf_____________
Date received by counselor:
_______________________
Date received in Records
Office: _______________
Attached:
 $5
 Fee waived (scholarship or free/reduced lunch)
 2 first class stamps
7th semester grades will automatically be mailed in mid February
3.
Date Sent: _____________
Initials: ________________
I have applied to ___________________________________________
College/university/scholarship
Address: _________________________________________________
_________________________________________________
_________________________________________________
Student, please check off necessary items:
Please send the following to this institution:
 Transcript/Profile
 Secondary School Report
 Counselor Letter of Recommendation
Application Due Date: ______________
OFFICE USE ONLY:




Early Decision
Early Action
Regular
Rolling
E-docs: N_________
Y_________
Conf_____________
Date received by counselor:
_______________________
Date received in Records
Office: _______________
Attached:
 $5
 Fee waived (scholarship or free/reduced lunch)
 2 first class stamps
7th semester grades will automatically be mailed in mid February
4.
Date Sent: _____________
Initials: ________________
I have applied to ___________________________________________
College/university/scholarship
Address: _________________________________________________
_________________________________________________
_________________________________________________
Student, please check off necessary items:
Please send the following to this institution:
 Transcript/Profile
 Secondary School Report
 Counselor Letter of Recommendation
Application Due Date: ______________
OFFICE USE ONLY:




Early Decision
Early Action
Regular
Rolling
E-docs: N_________
Y_________
Conf_____________
Date received by counselor:
_______________________
Date received in Records
Office: _______________
Attached:
 $5
 Fee waived (scholarship or free/reduced lunch)
 2 first class stamps
7th semester grades will automatically be mailed in mid February
Date Sent: _____________
Initials: ________________