Enrollment Services PO Box 130 McKenzie, TN 38201 731-352-4030 731-352-4241 (fax)

OFFICIAL TRANSCRIPT REQUEST FORM

STUDENT: Please send this completed form to each high school and college previously attended. For a GED, send this form to the test center where the exam was administered. Please be aware you are responsible to pay any transcript fees required by each school/program. HIGH SCHOOL COUNSELOR: Official transcripts: -must be on school letterhead or have an original stamp, seal or signature -show cumulative grade point average on a 4.0 scale -show documentation of ACT/SAT scores received -show class rank -final transcripts must include the date of graduation If your high school does not rank students, please include documentation to show whether or not the student placed in the top 50% of the class COLLEGE/GED RECORDS: Transcripts must be on official school/program letterhead or paper. Faxed transcripts are not considered official.

. Please print or type Name:_____________________________________________ Social Security #:_______________ Last

First

Middle/Maiden

Address:_________________________________________________________________________ Street

City

State

Zip

Name of high school/college/program:__________________________________________________ City/State:_________________________________ Year graduated/completed:________________

Permission is hereby granted for the release of my transcript to Bethel University. Student signature:_______________________________________ Date:____________________