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Belmont High School
Transcript Request
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* Indicates required question
Email
*
Your email
Name as it appears on school record:
Please supply the name as it would be listed on your transcript. Include maiden name if applicable.
Last Name, First Name, Middle Name
*
Your answer
Graduation Date (or last date of attendance)
*
MM
/
DD
/
YYYY
Current mailing address
*
Your answer
Last 4 digits of your Social Security Number
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Current Phone Number
*
Your answer
I wish to pick up an UNOFFICIAL copy of my transcript.
*
Yes
No
Required
Please send an OFFICIAL copy of my high school transcript to:
College/University Name
Your answer
Address of college/university
Your answer
Today's date
*
MM
/
DD
/
YYYY
Electronic Signature
By providing my electronic signature below, I authorize my transcript request to be processed.
Current legal name (First middle last name)
*
Your answer
A copy of your responses will be emailed to the address you provided.
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