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Bedford High School Request for Transcript Form

(All requests must be turned in to the Guidance Office at least one week before the transcript is needed.)

Date this request was given to the student/parent/alumni: _____/_____/_____

Date that this request was returned to the Guidance Office for processing: _____/_____/_____

Name you attended school under: ___________________________________________________

Last Name/Maiden Name, First Name, Middle Name or Initial

Year of Graduation: __________ or Year of Withdraw: __________

Transcript to be sent to: ____________________________________________

Address: ____________________________________________

____________________________________________

Reason for Request for Transcript:

_____College/School is requesting a transcript

_____Job Application/Interview

_____Scholarship (to be given to student and mailed by student)

_____Student/Unofficial/Personal Copy

(transcript will not have seal, signature of counselor, and date)

_____Other: For Example: (Proof of Birth for Social Security, etc)

*** There is no fee for a transcript, but we request that we receive an envelope that is addressed to the School listed above with the correct postage of one stamp included. All official transcripts must be mailed from the Guidance Office. ***

Student Signature (if 18 years of age or graduated): ______________________________________

(Your Signature will authorize Bedford High School to release a copy of your transcript to be sent to the location indicated above.)

Parent Signature (if student is under the age of 18______________________________________

(Your Signature will authorize Bedford High School to release a copy of your child’s transcript to be sent to the location indicated above.)

**Starting with the Class of 2004 – Transcripts will contain the following information: Quarter Grades, Final Grades, Credits Received, Class Rank, GPA, Days Absent and Days Tardy for each grade 9 thru 12. The Test Record Sheet will contain scores from the PSAT, SAT, and ACT Test. A copy of the resume you submitted to the Guidance Office will be attached to your transcript. **

For Office Use Only:

Date request was processed/mailed: ___________ Date Recorded in Transcript Book: __________