Billings West High School 2201 St. Johns Avenue Billings, MT 59102

Sherry D. Neill, Registrar Billings West High School 2201 St. Johns Avenue Billings, MT 59102 406-281-5604 406-281-6169 (fax) 406-655-3100 (office fax) [email protected]

There is a $3.00 charge per transcript REQUEST FOR ACADEMIC TRANSCRIPT The following information is to be completed by the requesting student if the student’s age is 18 or older, otherwise a Parent/Guardian must sign: Current Name:_________________________________________________________ Name on Transcript:____________________________________________________ Other Previous Names Used:_____________________________________________ Email Address_________________________________________________________ Current Address:_______________________________________________________ City:_________________________________State:______________Zip:__________ Telephone #:__________________ Date of Birth:____________________________________________ Last Date of Attendance:______________________________ Year Graduated:_______________________________________________________

_________________________________________________Date:_________________ Student Signature (if over 18 yrs.) or Parent/Guardian Name & Address where you would like the transcript sent: ________________________________________________________________________ ________________________________________________________________________