Transcript Request Form Name * First Name Last Name Email * Student ID (if available) Date of Birth (of person you are requesting transcript for) Phone (###) ### #### I am requesting the transcript of: (Please include their first & last name) School attended (Choose ONE): DreamYard The Urban Assembly Academy for History and Citizenship for Young Men Reason for transcript request: College/School Enrollment Employment Verification Other How would you like to receive the transcript? Email US Postal Mail If you would like us to mail the transcript, please include name and address below. Please confirm your request by putting your initials below: * Enter Today's Date MM DD YYYY We will respond to your request as soon as possible. If you additional immediate assistance, please contact 718-410-4242 and Dial 0 for our main office. Thank you! We will respond to your request as soon as possible. If you need immediate assistance, please contact 718-410-4242 and Dial 0 for our main office. Thank you!
