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Transcript Request

The following form is to be used to request transcript and/or immunization records for students that attended or graduated from an Elkhorn High School.

Requests must be made by the former student/graduate. Requests submitted by third party organizations will not be processed.

Graduates and Transfer students only.
Current seniors contact your counselor.

Company
This field is for validation purposes and should be left unchanged.
STUDENT INFORMATION
STUDENT NAME*
First Middle Last
STUDENT LEGAL NAME AT THE TIME OF GRADUATION*
First Middle Last
DATE OF BIRTH*
MM slash DD slash YYYY
HIGH SCHOOL*
- Elkhorn High School
- Elkhorn North High School
- Elkhorn South High School
DID THE STUDENT GRADUATE*
- Yes
- No
YEAR OF GRADUATION or LAST YEAR ATTENDED*
YEAR OF GRADUATION or LAST YEAR ATTENDED*
YEAR OF GRADUATION or LAST YEAR ATTENDED*
RECIPIENT INFORMATION
DOCUMENT TYPE*
- Official Transcript
- Unofficial Transcript
- Immunization
RECIPIENT NAME*
First Last
ORGANIZATION, INSTITUTION, and/or DEPARTMENT NAME
PHONE NUMBER*
Used only if we need to contact you
YOUR EMAIL*
Used only if we need to contact you
NEEDED BY*
Date the document is needed
MM slash DD slash YYYY
RELEASE DOCUMENT(S) VIA*
- Mail
- Email
- Fax
ADDRESS*
Enter the address where the document(s) will be sent.

Street Address Address Line 2 City State ZIP Code
EMAIL*
Enter the address where the document(s) will be emailed.
FAX*
Enter the number where the document(s) will be faxed.
OTHER COMMENTS
CONFIRMATION
CONFIRMATION EMAIL
- I would like to receive a confirmation email upon submission of this form.
EMAIL ADDRESS*

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Contact Us

Elkhorn Public Schools
20650 Glenn Street, Elkhorn, NE 68022

Phone: 402-289-2579
Fax: 402-289-2585

At Elkhorn Public Schools we strive to comply with web accessibility standards. To report a concern or to request assistance, please email us at accessibility@epsne.org.

The Elkhorn Public School District does not discriminate on the basis of sex, race, color, religion, military or veteran status, national or ethnic origin, marital status, age, disability, pregnancy, childbirth or related condition, or other category protected by law, in its programs and activities.

The following persons have been designated to handle inquiries regarding the non-discrimination Policies:
Students – Mark Kalvoda, Executive Director of Student Services, 20650 Glenn Street (402) 289-2579,(studentservices@epsne.org)
Employees and Others – Don Pechous, Executive Director of Personnel, 20650 Glenn Street (402) 289-2579, (Personnel Contact Form)
Complaints or concerns involving discrimination or needs for accommodation or access should be addressed to the appropriate Coordinator.

For further information about anti-discrimination laws and regulations, or to file a complaint of discrimination, contact the OCR at One Petticoat Lane, 1010 Walnut Street, 3rd Floor, Suite 320, Kansas City, Missouri 64106, (816) 268-0550 (voice), Fax (816) 268-0599, (800) 877-8339 (telecommunications device for the deaf), or ocr.kansascity@ed.gov.

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