Wapakoneta High School
One Redskin Trail
Wapakoneta, OH 45895
(419) 739-5201

REQUEST FOR TRANSCRIPT
(Please allow 24 to 48 hours for transcripts to be processed.)
NAME__________________________________________________________________________________
                             First                                     Middle                                  Last                                    Maiden (if applicable)

Year of Graduation or Withdrawal__________________              

Date of Birth________________________       Social Security Number____________________________

I am requesting Wapakoneta High School to release my high school transcript, which includes demographic information, social security number, date of birth, academic information, and test results, if any, to:

__________________________________________________________________________________________________________
Name of College/University/Business/Other
__________________________________________________________________________________________________________
Attention (Office or Person)
__________________________________________________________________________________________________________
Street Address and/or Post Office Box
__________________________________________________________________________________________________________
City                                                            State                                     Zip

Daytime Phone Number_______________________________

Signature______________________________________________     Date___________________________

Instructions
After completing the requested information and signing the above form, please return it to the Wapakoneta High School Guidance Office in one of the following ways:

•	Mail to the address shown above
•	Fax to 419-739-5305
•	Scan and e-mail to dirrki@wapak.org