I,
    (full name at time of schooling),

request a copy of my transcript or student records.

My personal information is as follows:

Date of Birth:

Last Yukon school attended:

Last Grade:

Last year at that school:

Graduated: Yes No

Contact number:

Contact email:

Instructions for issuance of records
(i.e. where to send them): - include a name, and address or fax number where appropriate.
 

Access to Information and Privacy Protection Statement

The personal information on this Transcript or Student Records Request form is being collected under the authority of the Education Act and is being used solely for the processing, handling and issuance of the appropriate records in accordance with the information supplied on the form. Any questions concerning the collection of this personal information may be directed to the Coordinator, Student Information at the Yukon Department of Education at the address above, or may be reached at (867) 667-3707.

Declaration

1. I certify that I am the named individual on the student record(s) or transcript(s) produced as a result of my request and as such, I have the sole authority to submit this request. I understand that identifying myself as someone else constitutes fraud.

2. I authorize the Yukon Department of Education to release my student records or transcript information to the destinations specified on this request.

Click on the 'Submit' button below to indicate that you have read and understood this declaration and by so doing you are providing the Yukon Department of Education the noted certification and authorization.