Transcript Requests

*Student's First Name

*Last Name

*Grade Last Attended

Due Date to College/Organization (mm/dd/yyyy)

*Date Last Attended (mm/dd/yyyy)

*School Name

*School Phone Number

*School Fax Number

*School Address

*School City

*School State

*School Zip Code

*School Email Address to Receive Records

*Your Email Address For Confirmation

By typing my name below, I, the undersigned, authorize Mt. Bethel Christian Academy to release a copy of my child's official school transcript including cumulative records, enrollment history, attendance record, and all standardized test results to the school named above.

*Electronic Signature of Parent/Legal Guardian

*Date (mm/dd/yyyy)