Text Box: HOME PAGE Text Box: United States Congresswoman Marsha  Blackburn; 2000 to present. Text Box:    School Transcript    _______________________      Financial Aid Transcript  ______________________    GED Scores            _______________________      Certificate or Diploma    ______________________       NET Scores            _______________________       Other                            ______________________      Records are to be mailed to the following address. Tennessee Technology Center at Pulaski

Lawrenceburg Extension Campus/Lewisburg Extension Campus

1233 East College St. / P.O. Box 614

Pulaski, TN 38478

Phone: (931)424-4014, (931)766-1478, (931)270-2271 Fax: (931)424-4017

Text Box: School Records Request Form

 

 

 

Text Box: ______________________________________________________________________________________    Name                                                                          Social Security Number   _____________________________________________________________________________________    Last Name Used While Enrolled                                  Dates of Attendance   _____________________________________________________________________________________    Name of Program                                                        Day, Night, or Special Industry      Please Release a copy of the following records:     

 

 

 

 

 

 

 

 

 

Text Box:    Name  ______________________________________________________    Address  _____________________________________________________    City ____________________  State _____  Zip Code __________________    I hereby authorize the release of my records as stated above.

 

Text Box:    Phone Number _________________________  Signature _____________________________________                                                                                                                                                                Date _________________________________________

 

Text Box: Please include a processing fee of $3.oo per transcript (School or GED), certificate or diploma requested.  Make check or money order out to the Technology Center and return request form and fee to Tabitha Davis at the above address.