Bloomfield Community Schools                 Request for Transcript
Your transcript is your high school record and cannot to released without permission of your parent/guardian or yourself if/once you are 18. By filling out this form, you are granting permission to Bloomfield Community Schools (BCS) to release your/your child's transcript to the schools or organizations listed below. This form will serve as a tracking log for our records. Transcript will be sent only upon electronic request only.
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Personal info
Student's First Name *
Student's Last Name (At Time of Graduation) *
Birthdate for Verification
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Student or Parent/Guardian Name
By signing this form, you are granting permission to Bloomfield Community Schools (BCS) to release your/your child's transcript to the schools or organizations listed below
Type name for signature
Email address *
Transcript Information
Date of Request *
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Year of High School Graduation *
Date transcript needs to be received by school *
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Type of transcript *
How do we distribute the transcript? *
To which school do we mail the transcript? *
If you said "other", please list which College or University.
Address of College/University *
Phone number of College/University
Fax number of College/University
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