Internal Transcript Request Form

Holt High School
Counseling Department 5885 W. Holt Road, Holt, MI 48842 Phone: 517-699-0291 Fax: 517-699-3451 Email: Transcripts@hpsk12.net
Student Transcript Request Form
Written permission is required to release/request student records. I hereby consent to the release of the records of:
mm/dd/yyyy
Last School Attended:
Help for Please send to the following address: Note: Colleges require
OR
Help for Picked Up (Include phone number below; we will contact you when your requested transcripts are ready for pick up.)
mm/dd/yyyy
GED records can be requested by contacting: Michigan Department of Energy, Labor and Economic Growth at 517-373-1692.