EVANGEL CHRISTIAN SCHOOL

Transcript, Records Distribution, or Withdrawal Request Form

Complete one form for each student to send their transcript and/or records from ECS to another institution.

NOTE: For the submission of this form to be acted upon by the school office:

1. all required ECS student records must be up to date at the school office, e.g., report cards, curriculum logs, attendance forms, etc., and

2. your ECS financial account must be in good standing.

Please allow 7-10 working days for the transcript to be processed and delivered to the institution.

STUDENT and PARENT

Student Name (as it appears on Social Security Card) *

DOB * +

Last Grade Completed at ECS *

Graduating Class Year *

Parent Name *

Email Address *

Purpose of transcript and/or records transfer *

If the records transfer is for student participation in public school sports, which sport will the student participate in?

If for withdrawal of this student, I have other children who will remain enrolled with ECS.

I understand that if all my student's curriculum logs, report cards, and attendance forms are not up to date with ECS ECS is unable to transfer records as requested. *

Acknowledged

I understand that if my account is not at a zero balance, ECS is unable to transfer records as requested. *

Acknowledged

INSTITUTION to receive records

Name of Receiving Institution *

Department

Contact Person

Mailing Address *

Address Line 2

City *

State *

Zip Code *

Email Address *

Include ACT Scores on transcript *

yes

Parent Signature (unless an alum) *

clear

* +

"Homeschooling to Know the Preeminence of Christ†"

Evangel Christian School does not discriminate based on race, color, or national and ethnic origin in administration of its educational policies and admission.