Diploma Request in Accordance to Act 155 A person (hereby referred to as "student") no longer enrolled in a public school who was denied graduation solely for failing to meet the exit exam requirements (S.C. Code Section 59-18-310(B)) may petition to determine his or her eligibility to receive a high school diploma. For more information about ACT 155 visit http://www.ed.sc.gov/newsroom/public-information-resources/high-school-exit-exam-elimination/. Please submit this form online by pressing the submit button. OR you may print and submit the completed, signed form by mail to: Janet Howe, Student Records Office, 1 Men Riv Drive, Goose Creek, SC 29445. OR submit in person at the Student Records Office. Incomplete information will delay processing. Allow 8-10 weeks for processing, printing and delivery. Primary Contact Information Primary Contact's Name: Primary Contact's Phone: Primary Contact's Email: Primary Contact's Current Address:                                         City:                                         State: Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming                                           Zip Code: Personal Information Student's First Name*: Student's Middle Name*: Student's Last Name*: Students Generation(Jr., II, Etc)**: Did student go by any other name in high school? If yes, what name?** Student's Date of Birth (mm/dd/yyyy): Previous School Information High School Name from which Student Would Have Graduated: Berkeley High Berkeley Middle College Cainhoy High Cane Bay High Cross High Goose Creek High Hanahan High Macedonia High Philip Simmons High St. Stephen High Stratford High Timberland High Did the Student attend Adult Education? Yes   No School Year in which Student Would Have Graduated: 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 *Should be the name given on the Student's Birth Certificate. **NOT a required field. All other fields are required.