Student Records

This application for permanent student records is only for the use of and must be submitted by the former student and may not be used by third party requestors.

Please Note:

Print out the Application for Student Records
Make sure you complete all fields on the application.
Mail your application along with a $3.00 money order (per request) to the address listed on the application.
No longer Free Requests
E-Pay Link

1. What is your present name and mailing address?

* Name (First, Middle, Last):

* Address:

Apt./Condo Number:

* City:

* State:

* Zip:

* Phone:

- -

* Email:

2. What is the purpose of this request? *

Verification of birth (for I.D.)

Verification of high school graduation

Request for elementary transcript or registration card

Request for high school transcript

Immunization records (1989-present)

DACA – Deferred Action for Childhood Arrival

3. Background Information:

What full name(s) did the applicant use while attending school?

* Applicant's Full Name: (First, Middle, Last)

Applicant's Former Full Name 1: (First, Middle, Last)

Applicant's Former Full Name 2: (First, Middle, Last)

* Gender:

Male

Female

Where was the applicant born?

* City:

* State:

* Country:

* Applicant Birth Date:

What are the name(s) of the applicant's parents or guardian?

* Applicant's Parent's name: (First, Middle, Last)

Applicant's Guardian's name: (First, Middle, Last)

Applicant's mother's maiden name:

*Complete the following information pertinent to the Chicago Public Schools attended by the applicant.

Name of (last) elementary school:

Year left or graduated:

Name of (last) high school:

Year left or graduated:

Day

Summer

Evening

4. Conditions:

Records information will not be released to anyone other than the former student who requests their records information unless the former student signs a release authorizing the transmittal of information to a third party (see below)
A college or university does not usually recognize transcripts unless they are mailed directly to the college or university by the local education agency (this office). Should you desire that a transcript be sent directly to you, our office will comply with your request, but the college or university for whom it is intended may not accept it.

5. Authorization for Release:

Please send to my attention at mailing address indicated above.

Please send my records to a third party. I authorize the records custodian of the Chicago Public Schools to release and mail my permanent student record information requested above to the following:

Company Name:

* Name or Attention to:

* Address :

Apt./Condo Number:

* City:

* State:

* Zip:

* Phone:

- -

(Format: 999-999-9999)

* Email:

Please Note:

Have you completed this online application before? *

1. What is your present name and mailing address?

2. What is the purpose of this request? *

3. Background Information:

4. Conditions:

5. Authorization for Release: