Bentley Community Schools

Request for Transcript

Please complete this request and:

• fax to 810-591-9451 or
• bring to Bentley High School – Main Office or
• mail to Bentley High School, 1150 N. Belsay Rd., Burton, MI, 48509 or
• email to amaxwell@bentleyschools.org

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.