Transcript Request- Former BMHS Student

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Berlin Middle High School

Guidance Office

550 Willard Street

Berlin, NH 03570

603-752-4122 ext 1504

Consent for Records Release by Adult Student

Please allow 10 business days for request to be processed

Email *

Record my email address with my response

Name: First/Last (maiden name) *

DOB: *

YYYY

Telephone Number: *

Year of Graduation OR Last Year Attended: *

Name of College/University/Trade School/Employment Agency: *

Address or email address to be mailed to: *

I am a former student of the Berlin School District and am over the age of 18.

By my signature below, I authorize the release of my transcript.

I consent to the use of electronic signatures.

I Consent *

Yes

Required

Signature: *

Date: *

YYYY

Submit

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