Student Record Request Form
Only the BISD student in need of their record should fill out this form. An incomplete form or any request not picked up after 30 days will be considered closed and will need to be resubmitted for processing. You will need to complete a new form for multiple requests to different individuals or institutes. BISD requires at least two full business day to process all requests. Peak periods may require additional processing time.
LAST NAME WHILE ATTENDING SCHOOL *
PLEASE PROVIDE FULL LEGAL NAME AT THE TIME OF ENROLLMENT (e.g. maiden name for females)
Your answer
FIRST NAME *
Your answer
MIDDLE NAME
(If applicable)
Your answer
SUFFIX
(If applicable)
Your answer
CURRENT NAME
If not the same as above
Your answer
DATE OF BIRTH *
MM
/
DD
/
YYYY
LAST 4 DIGITS OF SOCIAL SECURITY NUMBER *
If none, please state this
Your answer
FORM OF IDENTIFICATION *
You must provide BISD with proof of identity before your request can be processed. Your request will be considered incomplete until proof of identity is received. IF PROOF OF IDENTITY IS NOT RECEIVED WITHIN 30 DAYS, YOUR REQUEST WILL BE CONSIDERED VOID AND MUST BE RESUBMITTED.
Last Brazosport ISD School of Attendance
NAME OF SCHOOL *
GRADUATION YEAR/LAST YEAR ENROLLED *
ONLY 2018 GRADUATES AND PRIOR (2019 Graduates and Current Students contact the high school)
Your answer
Information for Delivery of Record
Official/Sealed transcripts cannot be faxed or e-mailed to any individual. Transcripts faxed or e-mailed to any individual will be considered a 'regular/unofficial' transcript. Records must be picked up at the BISD Administration Building, 301 Brazoswood Drive, Clute, TX 77531. If picking up a transcript, please be sure to have your valid I.D.
TYPE OF RECORD NEEDED? *
GRADE LEVELS NEEDED? *
FORM OF DELIVERY? *
Please select one
Required
PERSON/INSTITUTE/COLLEGE TO RECEIVE RECORD *
Required
E-MAIL ADDRESS TO SEND RECORD
(If Applicable)
Your answer
FAX NUMBER TO SEND RECORD
(If Applicable)
Your answer
MAILING ADDRESS TO SEND RECORD
(If Applicable)
Your answer
Student Contact Information
Telephone Number *
1(***) ***-****
Your answer
E-Mail Address
Your answer
How would you like to receive updates on your request?
SPECIAL INSTRUCTIONS OR REQUEST
Your answer
AUTHORIZATION NOTIFICATION *
I hereby give my consent for Brazosport ISD to release my academic transcript or form of student record to the party indicated above. I understand that by submitting my INITIALS below, this constitutes an electronic signature and confirms I have completed all sections accurately and truthfully including information verifying my identity. I declare under penalty of perjury that the foregoing is true and correct.
Your answer
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