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Request for Student Transcript and Immunizations

Complete this form to obtain your High School Transcript and/or Immunization Records. In order for us to process your request you must complete the form below. You will be required to attach a copy of your Photo ID.

If you prefer, you may submit your request via mail or fax. Complete the attached form. Please provide all information requested, and mail it in a business sized envelope.

You can fax us your request to (631) 972-1405.

You can mail us a request. Send to the following address:

Brentwood High School

Attn: Records Department

2 Sixth Avenue

Brentwood, NY 11717

Please allow up to five (5) working days to process your request.

*PICTURE ID MUST ACCOMPANY REQUEST

*STUDENT RECORDS WILL NOT BE RELEASED TO ANYONE OTHER THAN THE STUDENT, UNLESS APPROPRIATELY REQUESTED IN WRITING BY THE STUDENT.

Printable Transcript Request Form Download

What is the difference between an “Official Transcript” and a “Student Copy”?

~Colleges require an “Official Transcript”, which is signed, sealed and dated.

~We can send this directly to you or directly to the college.

~If we send this to you, you will receive a brown envelope, which you can open. Inside there will be a sealed white envelope marked, “Official Transcript”. Do not open this envelope. Give this to the college. There will be student copies in the brown envelope for you.

~An emailed version can also be sent directly to the college if email address is provided

Check appropriate box: *

Transcript (Official Copy)
Transcript (Student Copy)
Immunization

First Name: *

Middle Name:

Last Name (as it appears on school records): *

Full Current Name: *

Current Street Address: *

City: *

State: *

Zip Code: *

Email Address:

Year Graduated from Brentwood High School or withdrawn from district: *

Date of Birth: *

Daytime Phone Number: *

Fax Number:

Check method(s) of delivery: *

Email
Mail
Fax

Do you wish to have transcript sent to a School / Institution? *

Yes

Enter name of School / Institution:

Full Address for School / Institution:

Fax Number to School / Institution:

Email Address for School / Institution:

Please provide copy of your photo ID: *

List of Allowed file types

Submission

Type your name and sign below

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