Records Request

Parents/students should fill out this form when you need Primavera to send documentation to another school.

You may also send records to registrar@primaveratech.org.

STUDENT INFORMATION
Name*
First Last
DOB*
MM
DD
YYYY
Student ID*
Phone Number*
Email Address*
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent Phone (if student is under 18)
Parent Email (if student is under 18)
Where would you like the records sent?
Recipient Name*
First Last
Recipient Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Recipient Phone*
Recipient Email
Add Additional Recipient?
- Yes
2nd Recipient Name
First Last
2nd Recipient Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
2nd Recipient Phone
2nd Recipient Email
What records are you requesting, check all that apply.
Checkboxes with the following:
- Unofficial transcript
- Withdrawal Form
- Immunization Records
- Official Transcript (Mailed)
- Letter/Proof of enrollment/completion
- Diploma
- Other, please specify:
(Specify Here)
Special Instructions: