TRANSCRIPT REQUEST FORM
Contact: Ms. Jessica Martinez jmartinez54@schools.nyc.gov
1. Official transcripts will be mailed to the employer or school.
2. Unofficial transcripts will be sent to the location specified by the person requesting the transcript.
3. All transcript requests are $5.00; please include a money order made payable to “Queens Technical High
School” or bring cash to school with your request.
4. Please allow two weeks for transcripts to be sent. Most transcript requests will be mailed within three
business days of receipt of the application. We will attempt to mail all rush requests as quickly as possible,
but we cannot same day process any requests, nor can we process requests without payment.
Today’s Date: ____ / _____ / _____
Month Date Year
Last Name: ____________________________________ First Name: ___________________________
NAME AT TIME OF ATTENDANCE: _______________________________________________________
GRADUATION DATE: ____ / _____ / _____ (or DISCHARGE DATE: ____ / _____/ _____)
DATE OF BIRTH: ____ / _____ / _____
CURRENT ADDRESS: _________________________________________ APT #: ________________
Street
_______________________________ , __________ _____________
City State Zip Code
PHONE #: (__ __ __) __ __ __ - __ __ __ __
Area Code
TRANSCRIPT TO BE SENT TO:
1. NAME OF COLLEGE/EMPLOYER: ________________________________________
ADDRESS: __________________________________________________
Street
_____________________________ , ___________ _____________
City State Zip Code
2. NAME OF COLLEGE/EMPLOYER: ________________________________________
ADDRESS: __________________________________________________
Street
_____________________________ , ___________ _____________
City State Zip Code