Simply replace the unfilled areas such as "" and "[date]" with your information.
Dear Sir or Madam:
I am writing you to request my school [records/transcripts]. I attended [name of school institution] from [date] to [date]. You may forward these to me at the address shown below.
If there is a charge for copying the records, simply include an invoice, and I will remit payment when I receive the package. Thank you for your assistance.