Transcript Request Form

GRACE BAPTIST CHRISTIAN ACADEMY
Office of the Registrar * 1000 Oak Hill Avenue * Attleboro, MA 02703
(508) 222-8675 * [email protected]

* Indicates required field

Fees: * First three (3) requests, Free
* $5.00 each thereafter (receipt of payment to be received prior to the release of records)
* Express Mail/Priority Mail fee, $10.00 / Overnight Mail fee $20.00 (receipt of payment to be
received prior to the release of records INCLUDING 1st three requests)
Payment Methods: Cash, Check (make payable to Grace Baptist Christian
Academy), Credit Card (all emailed requests must include charge card # and expiration date)

Name as it appears on the Credit or Debit Card *

First

Last

Credit Card Numer *

Expiration Date *

CV Code *

Type of Card *

Master Card Visa Amex Other

Transcript requests are processed as quickly as possible and are usually mailed within two (2) business days following receipt, providing that all the information included, all financial obligations are cleared, and all school property is returned except during peak periods.

TRANSCRIPTS CANNOT BE RELEASED UNLESS ALL FINANCIAL OBLIGATIONS TO GBCA ARE CLEARED

Student Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Maiden Last Name *

Email *

Phone Number *

Date of Birth *

Social Security #: (last 4 digits only) *

Dates Attended Grace Baptist Christian Academy

Month/Year Start *

Month/Year Ended *

Please mail my transcripts to: *Only schools can receive official transcripts. Individuals can only receive unofficial transcripts. *

Official Transcript Unofficial Transcript

School A) Name & Address *

Line 1

Line 2

City

State

Zip Code

Country

School B) Name & Address *

Line 1

Line 2

City

State

Zip Code

Country

School C) Name & Address *

Line 1

Line 2

City

State

Zip Code

Country

Authorized Signature *

First

Last

Date Signed *

In accordance to the 1974 Family Education Rights and Privacy Act and applicable amendments, a request for a transcript must be submitted in writing, signed,
and dated by the person giving such consent. It should also include the name/address of the party who is to receive them.

Submit