Westside High School Diploma/Transcript Pickup Authorization Form

Diploma/Transcript Pickup Authorization Form

Please complete and sign this form to authorize someone else to pick up your Diploma or Transcript on your behalf.
Year Graduated/Last Attended
Graduate's/Student's Full Name

First NameMiddle InitialLast Name
Birth Date

MonthDayYear
Take a picture of your photo ID (Student ID or Driver's License)
Name of the Person picking up your Diploma (As they appear on their State-issued ID)

First NameLast Name
By signing below, I verify that I am the graduate authorizing the person named above to pick up my High School Diploma from Westside High School on my behalf.
Should be Empty: