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  • 2022 Records Request Form

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    Allison Stock
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    This document is a records request form from the Parkway School District student records office. It contains a student's request to have their high school transcript sent to a specific organization. The form provides the student's name, date of birth, last school attended, date of graduation, and a signature authorizing the release of records. It directs the transcript to be faxed or emailed to the Joint Apprenticeship and Training Committee with the requested fax number and contact information provided.

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    This document is a records request form from the Parkway School District student records office. It contains a student's request to have their high school transcript sent to a specific organization. The form provides the student's name, date of birth, last school attended, date of graduation, and a signature authorizing the release of records. It directs the transcript to be faxed or emailed to the Joint Apprenticeship and Training Committee with the requested fax number and contact information provided.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    12 views1 page

    2022 Records Request Form

    Uploaded by

    Allison Stock
    This document is a records request form from the Parkway School District student records office. It contains a student's request to have their high school transcript sent to a specific organization. The form provides the student's name, date of birth, last school attended, date of graduation, and a signature authorizing the release of records. It directs the transcript to be faxed or emailed to the Joint Apprenticeship and Training Committee with the requested fax number and contact information provided.

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    © All Rights Reserved
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    of 1

    STUDENT RECORDS OFFICE

    PARKWAY SCHOOL DISTRICT


    760 WOODS MILL RD.
    BALLWIN, MO 63011
    FAX: (314) 415-9050
    Initials

    aanderson2@parkwayschools.net

    RECORDS REQUEST FORM


    DATE: 1/10/2023

    If record is to be hand-carried, identification is REQUIRED. Written authorization MUST BE PROVIDED


    (by former student 18 years of age or older) for any other person to pick up copy of record. If parent is
    still supporting student, then authorization from student is not required.

    Please check each item requested:  Graduation Verification Letter (Do


     Elementary/Junior High/Middle School Record not need if transcript is requested.)


    ✔ * High School Transcript (including ACT/SAT Scores)  Driver Education Verification Letter
    Date Completed

     Complete Educational Record  Immunization Record


    Name used while attending Parkway school: (Please print)
    Mueller Allison Ann 05/03/1995
    Last First Middle Date of Birth
    Name of LAST PARKWAY School Attended Parkway South Highschool
    Month/Year Left Parkway 05/2013 Graduate? Yes 
    ✔ No Grade level at time of Withdrawal

    Where do you want us to send Record/Transcript:

     1. Send to College/University (Official)  5. Self/Personal (Unofficial)


     2. Student Hand-Carry to Institution (Official)  6. Send to Vocational/Technical School (Official)
    (Make sure institution will accept as official)
     3. Scholarship/Financial Aid Application (Official)  7. Elementary/Junior High/or High School (Official)
    First Name


    ✔ 4. Employer (Official)  8. Military (Official)
    * If an OFFICIAL high school transcript is requested for use by a college, university, vocational school or
    potential employer, the transcript must be mailed directly from this office, unless institution approves a hand-
    carried/faxed copy. Provide the complete name and address of where you would like your transcript sent by
    our office below. Please include address and fax number if you wish records to be faxed and mailed.)

    They have approved a copy to be faxed or emailed.


    Email : jatc@kcjatc124.org
    Fax : 816-942-0854

    Fax Number/Contact Name: 816-942-0854 / JATC 124 - I0673 Mueller-Stock A


    OFFICE USE ONLY

    Signature (Must have signature to process):


    Relationship to student: Myself
    Last Name

    Student print present name if different from record: Allison Mueller-Stock


    Student’s Current Address: 8110 Hardy Ave
    City/State/Zip Raytown Mo 64138 Contact Phone: 660-221-0509
    Please check here ___ if you do not wish address information released to the Parkway Alumni Association.
    Parkway School District
    Form #224B (Rev. 9/22)

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