32 West Main Street #5
Waynesboro, PA 17268
Office: 717-749-5767 (Call Office number first!)
Gmail phone: 717-925-0585

Transcript Request Form – Part 1 of 2: Student & Institution Information

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NOTICE:  The MDHSA Office cannot fill Transcript Requests made by 3rd parties (i.e. employers or facilities requesting education verification).  All Transcript Requests must be made by the student / family.  Any other party requesting a Transcript will have their order cancelled.  For education verification, please email diploma@pa.net.

Please allow up to 2 weeks to process a Transcript Request.  If the request must be processed in 7 business days or less (excluding office closures and holidays), an ADDITIONAL $15.00 RUSH fee must be added to the total cost of the Transcripts.  (For RUSH orders, please pay the original Transcript fee PLUS the $15.00 RUSH fee.)

You will not receive confirmation that the request was filled.  Please keep your online receipt.  Transcripts will be mailed to the addresses that are listed on the form.  Do not include shipping / mailing instructions on your PayPal Payment page.  If there is an error with your order, you will be notified via the email address on file with your PayPal account.

To pay online using PayPal, fill out the online form (below).

This is part 1 of 2. Be sure to fill out part 2, which you will be forwarded to automatically after completing this step.

FEES: Transcripts are $5.00 each. Additional Charge: RUSH processing -- Add $15.00 to the transcript total. Payment will take place in step 3.

Student Information:
* indicates required field

Institution Information:
While Transcripts are usually sent within a week or less, MDHSA reserves the right to allow two weeks to process this request. List below any colleges or other parties that you desire MDHSA to send official transcripts to (if more than four, please fill out separate form):
Check here if you need the transcripts below sent to your address and each must be in a separate, sealed envelope and stamped across the envelope seal--usually to hand carry to several colleges. If this is not checked, and you order multiple transcripts sent to your address, then the transcripts will be loose in one large envelope.)

MDHSA does not discriminate against families on the basis of race, color, national or ethnic origin.

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