sally

The Lab School of Washington

Sally L. Smith, Founder 4759 Reservoir Road, Northwest • Washington, DC 20007• 202-/965-6600
www.labschool.org

                               RELEASE OF STUDENT TRANSCRIPT

Student Name:__________________________ Year left LSW: ___________Phone:________________

**The fee for each official transcript is $10.00

Please enclose your check with your request paid to the order of: The Lab School of Washington
All requests go to the Registrar’s Office: 202-944-2236 or 202-944-2235

Signature:________________________ Print Name: ___________________________ Date:____________

(Parent signature if student is younger than 18)

I hereby request that copies of a transcript be

a) picked up at The Lab School of Washington;

or
b) forwarded to the following addresses, schools, colleges or universities:

______________________________________ _______________________________
(Name, College and/or University) Telephone No.

______________________________________ _______________________________
(Street Address) (City, State, Zip Code)

______________________________________ _______________________________
(Name, College and/or University) Telephone No.

______________________________________ _______________________________
(Street Address) (City, State, Zip Code)

______________________________________ _______________________________
(Name, College and/or University) Telephone No.

______________________________________ ________________________________
(Street Address) (City, State, Zip Code)

(Use reverse side for additional addresses if needed.)