<p> PIONEER HIGH SCHOOL RECORDS RELEASE FORM Pioneer High School PO Box 639 Yorkshire, NY 14173 Fax : (716) 492-9350 Phone : (716) 492-9334</p><p>Please note that transcripts are usually mailed within 48 business hours from the time your request is received. You will be notified by phone if there will be a delay in sending out your records. </p><p>Name (please print) : ______(Please include maiden name or any other name you may have used while at Pioneer) </p><p>Date of Birth: ______Year of Graduation: ______</p><p>Phone Number: ______Cell Home Work Other</p><p>Please check all that apply: _____ Official Transcript </p><p>_____ Unofficial Transcript </p><p>_____ Immunization record </p><p>_____ Other Records: please specify ______</p><p>Send to : ______</p><p>______</p><p>______</p><p>Please be advised that your transcript will not be released to anyone without your signature.</p><p>______Signature Date </p><p>For Office Use Only</p><p>Date received: ______Date mailed: ______Initials: ______</p>