FLA Transcript Request

FAITH LANDMARKS ACADEMY

TRANSCRIPT REQUEST
Name of Student
Date of Birth

MonthDayYear
Date
Please send the following information:
- Scholastic records
- Immunization and Health record
- Standardized test scores
- Any diagnostic tests that have been administered
- Discipline records
Current School should mail back to:

Principal, FAITH LANDMARKS ACADEMY
8491 Chamberlayne Road
Richmond, VA 23227
Phone 804-262-8256 fax: 804-266-7127
NOTE: We do not enroll families with an unpaid balance to a prior school. Please inform us if the above student's account is not paid in full to your institution by the end of the school year.
Does this family owe your school any outstanding balances?
If yes, please explain:
DISCIPLINE INFORMATION: Has this student ever been suspended or expelled from school?
If yes, when:
Please explain:
Please attach a copy of the expulsion/suspension notice.
File Upload

Cancelof
Signature of Principal
Date

MonthDayYear
Date
AUTHORIZATION STATEMENT AND SIGNATURE
TO: (previous School Name & Address)
I authorize you to release the information specified above to FAITH LANDMARKS ACADEMY.
Signature of Parent or Guardian
Date

MonthDayYear
Date
Should be Empty:

FAITH LANDMARKS ACADEMY