Middle School Transcript Release Form

I hereby authorize Western Academy to release the middle school academic transcript, standardized test scores, and immunization record of my son to the high school(s) I checked below.
Middle School Transcript Release Form
Your Name

FirstLast
Your Email Address
example@example.com
Your Son's Name

FirstLast
8th Grade Teacher
Select one or more High Schools where your son's documents will be sent to:
If there are other schools not listed above please enter them in the boxes below.
Other School Name #1
Other School Name #2
Other School Name #3
Other School Name #4
If you have any questions, please reach out to Alex Hoff, at alex.hoff@westernacademy.net or via phone at 713-461-7000
Parent Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: