Alumni Transcript Request | Florence Public School District One Transcripts and Records Requests

This is an official request for an aspect of the student record. The information contained in this request should be considered private. Please complete all information in full and then finalize the order process through by completing the 'captcha'.

Act 155 (H.3919) passed by the General Assembly and signed into law by Governor Nikki R. Haley on April 14, 2014, states in part "Beginning with the graduating class of 2015, students are no longer required to meet the exit examination requirements set forth in this section and State Regulation to earn a South Carolina high school diploma."

A person who is no longer enrolled in a public school and who previously failed to receive a high school diploma or was denied graduation solely for failing to meet the exit exam requirements may petition the local school board to determine the student’s eligibility to receive a high school diploma. The elimination of the exit exam (BSAP, HSAP) requirement is retroactive to the graduating class of 1990.

In order to facilitate the requirements of Act 155, Florence School District One has created a form that can be filled out by a petitioner who meets the requirements mentioned in the above paragraph. Please read the guidelines document located at Act 155 Guidelines, and if you meet those qualifications, fill out the Petition form and follow the directions for submission.

Please allow 8-10 weeks for processing, printing, and delivery.

All petitions must be filed by December 31, 2015.

Name While Attending School:

Last Name: ^{(in school)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Last 4 SSN:

Last 4 SSN: ^(confirm)

Student ID:

Information Related To Your Birth:

Date of Birth:

Current Age:

Birth City:

Birth State:

Birth Country:

Parent / Guardian Names:

Mother's Last Name:

Mother's First Name:

Father's Last Name:

Father's First Name:

Your Last Florence County School of Attendance:

Name of School :

Last Year Enrolled:

Did you graduate?

Yes No

Summer School:

Attend Summer School?

Yes No

When: ^{(last year)}

Night School:

Attend Night School?

Yes No

When: ^{(last year)}

Current Name / Requester Name:

Last Name: ^{(official id)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Current Residence Address: ^{(this may be different than the mailing address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Current Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

Telephone Number: ^{(###-###-####)}

^Primary:

^Cell:

Updates via Text Message?

Yes No

Driver's License: ^{(or other State Issued ID)}

^{ID Number:}

^{Issuing State:}

Email:

^Address:

^Confirm:

Special Instructions :

Documents Will Be Delivered To: ^{please enter the delivery addresses}

	Name	Attention	Addr 1	Addr 2	City	State	Zip	Country	# of Copies

Reason(s) for Request of Student Record:

Employment

College

Identification

Birth Certificate

Other

Select The Information Type(s) Requested:

SC Act 155 Diploma Request

( $0.00 ea. + $0.00 copy )

Total Fee:

AUTHORIZATION NOTIFICATION:

My initials below constitute an electronic signature and authorizes the Student Records Department of the Florence Public School District One to release information and / or my student record and confirms I have completed all sections accurately and truthfully, including information verifying my identity. I understand that the recipient of the record(s) will use the indicated documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other part or agency without my expressed written consent except under authority of Public Law 93-380, Educational Rights and Privacy Act.

I have enclosed the correct fees and understand that they are refundable. I understand that an incomplete form will not be processed and will be considered closed after expiration of the 30 day notification window. I declare under penalty of perjury that the foregoing is true and correct.

Please enter your e-Signature

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Online SC Act 155 Request Step 1, Please Enter All Information