Northbrook High School
Registrar's Office
ACADEMIC RECORD RELEASE FORM

  

Northbrook High School is authorized to release a transcript (Academic Achievement Record) for:

 

  
Mr.   Miss   Mrs.   Ms.   

  


DATE OF BIRTH
LAST NAME FIRST NAME MIDDLE OR MAIDEN NAME
--
SOCIAL SECURITY NUMBER

PRESENT ADDRESS (NUMBER AND STREET OR BOX NUMBER)

TELEPHONE NUMBER
CITY  STATE ZIP CODE

DATE OF REQUEST

Please select type of transcript needed:

Note:  An official transcript must be mailed by Northbrook High School.

Applicant is responsible for address.  Complete one form for each separate address.

Forward Transcript To:

   

COPY CHARGES, PAYABLE AT TIME OF REQUEST

$2 paper in/out of state

$2 electronic in state

Requests are processed within 1 working day, more time is required at the end/beginning of semester.


Number Requested

 
Check if you are enrolled now or give date of last enrollment Did you graduate? Yes  No

Student ID number
Do you wish final grades you are taking to appear on this transcript?  Yes  No     
 
The Family Educational Rights and Privacy Act of 1974 establishes the privacy rights of students (parents if the student is under 18) with regard to educational records. The act makes provision for inspection, review and amendment of educational records by the student and requires, in most instances, prior consent from the student for disclosure of such records to third parties. The consent must be in writing, signed and dated by the student and must specify records to be released, the reason for the release, and the names of the parties to whom such records will be released. The act applies to all persons formerly and currently enrolled at an educational institution. No exclusion is made for non-U.S. citizen students. However, the act does not apply to a person who has applied for admission, but who never actually enrolled in or attended the institution, and deceased persons.


 

   IDENTIFICATION REQUIRED
  Requested by __________________________________

Parent ________________________________

(signature)

(required for students under 18)

FOR OFFICE USE ONLY:

          
Date Transcript Sent         

Processed  by___________

Mail or Fax the signed request along with payment and a copy of ID to:

Registrar's Office
Northbrook High School
#1 Raider Circle
Houston, Texas 77080
Fax: (713) 365-4416