ࡱ> KNJU t1bjbjnn 86aa  hhh||||T4|&-6cw 1&3&3&3&3&3&3&$(+PW&-hu-W&&.h1&1&:#,(@${Ag^)$ &&0&3$R++$$+h$W&W&&+ B N: CONSENT TO RELEASE PUPIL RECORDS ERIE HIGH ROYALS 3325 Cherry Street, Erie, Pennsylvania 814-874-6200/Email: rwroblewski@eriesd.org  HYPERLINK "http://www.eriesd.org" www.eriesd.org  FORMCHECKBOX  Erie High School  FORMCHECKBOX  Central/Central Tech  FORMCHECKBOX  Tech  FORMCHECKBOX  East High School  FORMCHECKBOX  Strong Vincent Date: My name will be found under the name of Last (Maiden) First Current Address: City State Zip Date of Birth: Social Security Number (Last 4):  Telephone Number: Graduate  FORMCHECKBOX  Yes, Year Graduated:  FORMCHECKBOX  No, Last year attended:  FORMCHECKBOX  Evening School. Year attended:  FORMCHECKBOX  GED. Year attended: I will graduate at the conclusion of the school year 20 Name of Counselor: Permission is granted to the principal of Erie High School 3325 Cherry Street, Erie, PA 16508 to release academic, health, directory information, etc. for the student whose name appears above. Also for job placement purposes, and includes teacher recommendations.  Signature of Student If under 18 years of age, then Parent/guardian must sign. Signature of Parent/Guardian Please send my transcript to: _____________________________ Name of College, Employer, etc. _____________________________ Address City State Zip  Office Use Only: Name Title LEGEND Grade 11 & 12 Course Level Quality Points Point Scale AP Honors Reg. A (93-100) 6 6 4 B (85-92) 5 4 5 C (77-85) 4 3 2 D (70-76) 1 1 1 F (69% or below) 0 0 0 W (Withdrawal) LEGEND Grade 9 & 10 Course Level Quality Points Point Scale AP Honors Reg. Mastery 6 5 4 Proficiency 5 4 3 Satisfactory 4 3 2 Unsatisfactory 0 0 0 W (Withdrawal) IMPORTANT % Did you take the ACT Test? % No % Yes, Month & Year Taken: __ Did you take it once or !+12Yfmtu{ogXoPD> hE@CJhyy:hyy:5CJaJhCJaJjhyy:CJUaJhyy:CJaJjhyy:CJUaJhvv0JCJ hvvCJjhvvCJUh`ph|S6CJhra6>*B*CJphhE@hE@6>*B*CJph hE@6CJ h|6CJh`phK6CJh`phD56CJh< 56CJh`ph`p56CJh`ph .5CJaJ!2Y{ |   L N b c gd` f!gd` gdK  gdgdK$ !a$gd$a$gd $a$gdK   ! 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