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Transcript Release Form

I authorize the appropriate officials at Ponca High School to release to the Office of Admissions at the college(s) and/or business below an official transcript of my academic and test performance while a student at the institution.

 

_________________________________________________

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_________________________________________________

_________________________________________________

 

(College/Business Address)

 

 

_________________________                ______________________

(Name)                                                      (Date)

 

 

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Ponca School 505 3rd Street Ponca, NE  68770

402.755.5700 Fax: 402.755.5773

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The Ponca Public School District does not discriminate on the basis of sex, disability, race, color, religion, veteran status, national or ethnic origin, age, marital status, pregnancy, childbirth or related medical condition, or other protected status in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. The following persons have been designated to handle inquiries regarding the non-discrimination policies:

Students: Mr. Jody Phillips, Superintendent of Schools, PO Box 568, Ponca, NE 68770 (402) 755-5700 (jodyphillips@poncaschool.org).

Employees and Others: Mr. Jody Phillips, Superintendent of Schools, PO Box 568, Ponca, NE 68770 (402) 755-5700 (jodyphillips@poncaschool.org).

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 with the Office for Civil Rights in the U.S. Department of Education (OCR), please contact 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.