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STUDENT INFORMATION NAME: Joe Sample ADDRESS: 111 Street Name ST Apartment A Lynchburg, VA 24502 PARENTS: Father and Mother BIRTHDATE: January 1, 1987 GENDER: MALE GRADE: 12 2002-2003 SCHOOL YEAR Year 1 COURSE English 9 Physical Science Pre-Algebra Spanish Bible 10 GRADE D/D C/C B/B C/B C/C CREDITS 1.00 1.00 1.00 1.00 1.00 CREDITS 1.00 1.00 1.00 1.00 1.00 CREDITS 1.00 1.00 1.00 1.00 1.00 CREDITS 1.00 1.00 1.00

2003-2004 SCHOOL YEAR Year 2 COURSE GRADE English 10 C/C Natural Science B/B Algebra 1 B/B Government A/A World History B/A 2004-2005 SCHOOL YEAR Year 3 COURSE GRADE English 11 B/B Natural Science B/B Chemistry A/B Creative Writing B/A US History B/B 2005-2006 SCHOOL YEAR Year 4 COURSE GRADE English 12 A/B Algebra II A/B Advanced Writing B/C PERFORMANCE INFORMATION: Total Credits Earned: 17.00 Total Credits Attempted: 18.00 Cumulative GPA: 3.00 Date of Graduation: JUNE 19, 2006

I certify that this student has completed the equivalent of a secondary education and that it abides by the state standards. Date of Completion: mo/day/year ____________ Signature of Parent/Guardian/School Administrator ___________________________

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March 11, 2009

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