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Bentley Community Schools

Request for Transcript

Please complete this request and:

PRINT ALL INFORMATION

Name:  ______________________________________________________________

Telephone(s):  ___________________________________________________

Graduation Year:  ______________              Date of Birth:  ______________

Did you walk with your class or did you complete summer work to earn your diploma?

_______  Walked with class                ________  Summer work

What was your full and legal name when you graduated from Bentley High School?

_______________________________________________________________________

Please choose one of the following options:

________  I will pick up the transcript

________  Fax the transcript to: _____________________________________

________  Email the transcript to: ___________________________________

________  Mail the transcript to:

______________________________________________________________

__________________________________________        __________________

Signature                                                                        Date

The process of transcript retrieval can take 3-5 business days.