Request Form
To request a transcript from LightStars Academy, please complete this form in full. Be sure to include a payment, if applicable, and mail this form to the address listed below. Allow 7–10 business days for processing. All requests are handled with confidentiality.
Student Information
Full Name: ____________________________________________
Date of Birth: ________________________________________
Student ID (if applicable): ____________________________
Address: _____________________________________________
City: _________________________ State: ________ ZIP: ___________
Transcript Details
Type of Transcript
- Official Transcript (Sent directly to recipient; sealed envelope)
- Unofficial Transcript (For personal use)
Number of Copies Requested: ____________________________
Purpose of Request:
- College/University Admission
- Scholarship Application
- Employment
- Personal Use
- Other (Please specify): ______________________________
Delivery Information
Recipient 1
Name/Organization ____________________________________
Address _____________________________________________
City _________________________ State ________ ZIP ___________
Recipient 2 (if applicable):
Name/Organization ____________________________________
Address _____________________________________________
City _________________________ State ________ ZIP ___________
Delivery Method
- Standard Mail
- Pick-Up (If applicable)
Authorization and Signature
By signing below, I authorize LightStars Academy to release my transcript as specified in this request.
Signature of Student (or Parent/Guardian if under 18)__________________________________________________
Date_______________
Payment Information (if applicable)
Fee per Transcript Copy: $ 10.
Total Amount Enclosed: $________
Make checks payable to LightStars Academy.
Mail to: LightStars Academy, 18555 E. Smoky Hill Rd., Box 461442, Centennial, CO 80046
Office Use Only
- Date Received: _______________________________________
- Processed By: ________________________________________
- Date Sent: ___________________________________________
Thank you for your request. If you have any questions, please contact us at registar_LightStarsAcademy@aol.com.