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xxx-xx-
You must use this email in step 2 (payment) in order for payment to proccess.
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$$Destination1_Name1$$
$$Destination1_Name2$$
$$F4$$
$$Destination1_Address2$$
$$Destination1_City$$, $$Destination1_State$$ $$Destination1_ZipCode$$
$$Destination1_Country$$




Expedite Service = $22.00 per address (US Addresses Only, PO Box delivery not available with this option) Expedited services are currently unavailable

Attendance (1995 - present) = $2.00

State Standardized Testing (1995 - present) = $2.00

Immunization (1995 - present) = $2.00
Level School Name Did You Graduate Last Year Attended/Graduation Year
Charter Alumni / Closed Charter / Closed Private K-12 Did You Graduate Last Year Attended
I acknowledge that selecting a technical school is a separate fee in addition to other schools selected.
Technical College Course Title Did You Graduate Last Year Attended/Graduation Year

$$Destination2_Name1$$
$$Destination2_Name2$$
$$Destination2_Address1$$
$$Destination2_Address2$$
$$Destination2_City$$, $$Destination2_State$$ $$Destination2_ZipCode$$
$$Destination2_Country$$




Expedite Service = $22.00 per address (US Addresses Only, PO Box delivery not available with this option) Expedited services are currently unavailable

Attendance (1995 - present) = $2.00

State Standardized Testing (1995 - present) = $2.00

Immunization (1995 - present) = $2.00
Official Copy = $3.00*
Certified Copy = $7.00*
School Level School Name Did You Graduate Last Year Attended/Graduation Year
Charter/Closed Private K-12 Did You Graduate Last Year Attended
I acknowledge that selecting a technical school is a separate fee in addition to other schools selected.
Technical College Course Title Did You Graduate Last Year Attended/Graduation Year

$$Destination3_Name1$$
$$Destination3_Name2$$
$$Destination3_Address1$$
$$Destination3_Address2$$
$$Destination3_City$$, $$Destination3_State$$ $$Destination3_ZipCode$$
$$Destination3_Country$$




Expedite Service = $22.00 per address (US Addresses Only, PO Box delivery not available with this option) Expedited services are currently unavailable

Attendance (1995 - present) = $2.00

State Standardized Testing (1995 - present) = $2.00

Immunization (1995 - present) = $2.00
Official Copy = $3.00*
Certified Copy = $7.00*
School Level School Name Did You Graduate Last Year Attended/Graduation Year
Charter/Closed Private K-12 Did You Graduate Last Year Attended
I acknowledge that selecting a technical school is a separate fee in addition to other schools selected.
Technical College Course Title Did You Graduate Last Year Attended/Graduation Year

$$Destination4_Name1$$
$$Destination4_Name2$$
$$Destination4_Address1$$
$$Destination4_Address2$$
$$Destination4_City$$, $$Destination4_State$$ $$Destination4_ZipCode$$
$$Destination4_Country$$




Expedite Service = $22.00 per address (US Addresses Only, PO Box delivery not available with this option) Expedited services are currently unavailable

Attendance (1995 - present) = $2.00

State Standardized Testing (1995 - present) = $2.00

Immunization (1995 - present) = $2.00
Official Copy = $3.00*
Certified Copy = $7.00*
School Level School Name Did You Graduate Last Year Attended/Graduation Year
Charter/Closed Private K-12 Did You Graduate Last Year Attended
I acknowledge that selecting a technical school is a separate fee in addition to other schools selected.
Technical College Course Title Did You Graduate Last Year Attended/Graduation Year

$$Destination5_Name1$$
$$Destination5_Name2$$
$$Destination5_Address1$$
$$Destination5_Address2$$
$$Destination5_City$$, $$Destination5_State$$ $$Destination5_ZipCode$$
$$Destination5_Country$$




Expedite Service = $22.00 per address (US Addresses Only, PO Box delivery not available with this option) Expedited services are currently unavailable

Attendance (1995 - present) = $2.00

State Standardized Testing (1995 - present) = $2.00

Immunization (1995 - present) = $2.00
Official Copy = $3.00*
Certified Copy = $7.00*
School Level School Name Did You Graduate Last Year Attended/Graduation Year
Charter/Closed Private K-12 Did You Graduate Last Year Attended
I acknowledge that selecting a technical school is a separate fee in addition to other schools selected.
Technical College Course Title Did You Graduate Last Year Attended/Graduation Year

I authorized Broward Public Schools to release the indicated information and / or my education record. I confirm I completed all sections accurately and truthfully, including information verifying my identity.


I certify, under penalty of perjury, pursuant to Florida Statute Section 92.525, that I am the former/student requesting my records, or the parent/guardian of a former student (who is under the age of 18 or meets other statutory requirements ) requesting records of said student. I declare under penalty of perjury that the foregoing is true and correct.

*Request will be refused and refunded if there is not a full signature



Please attach a copy of your state issue ID below.

If applicable please attach supporting documents below
ex : Legal name change docs, 3rd Party signed documents, etc...


ID Name Number of Copies Price
B9858-1 Transcript Request - Official Copy 0 $0.00
B9858-2 Transcript Request - Certified Copy 0 $0.00
B9858-5 Immunization Record 0 $0.00
B9858-4 State Standardized Testing 0 $0.00
B9858-3 Attendance Report 0 $0.00
B9858-6 Expedite Service 0 $0.00
Total: $0.00