Student Transcript Request Form

Download a blank fillable Student Transcript Request Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Student Transcript Request Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Customer Service Center (CSC)
2700 Judge Fran Jamieson Way
Viera, FL 32940
Ph: 321-633-1000 ext. 500
S
T
/R
R
F
TUDENT
RANSCRIPT
ECORDS
EQUEST
ORM
This form is used to request transcripts/records for students who last attended Brevard County public schools. Complete all
information requested below. Incomplete forms will not be filled. A signature and legal copy of photo identification is required.
The requested records will be mailed within five (5) business days after receipt of a completed request. MAIL or bring to The School
Board of Brevard County, CSC, (all years of attendance/graduation), 2700 Judge Fran Jamieson Way, Viera, Fl 32940 or to the last
school attended (1996 and after) , along with appropriate fees. Fees may be paid by cash or money order. No personal checks or
debit/credit cards.
Fee Schedule
Fee Schedule
 Currently enrolled students (obtain from current school)
 Non-enrolled student (over one year after graduation)
Obtain from CSC (all years) or last school attended (after 1996)
Up to one year after graduation (obtain from CSC or former school)
$5.00 per copy
$1.00 per copy
Name(s) used while attending school (first, middle, last)______________________________________________________________
Current name (if different than above – first middle, last) _____________________________________________________________
Current address ______________________________________________________________________________________________
Student birth date _______________________________Current daytime telephone # ______________________________________
Did you graduate?  Yes  No
Last year in school_______________
If no, indicate last grade attended _____________
Name of last public school attended in Brevard County (including K-12, adult education, etc.) ________________________________
Indicate which records you are requesting (Check all that apply):
Number of copies you are
 High/Middle School Transcript  Elementary School Records Immunization Records
requesting: ____________
 Adult Ed
 GED
Indicate how you wish to receive the records:
 Mail
 Pick-up by student  Pick-up by person other than student (this person must provide legal photo ID)
Legal name of person picking up the transcript _________________________________________ _____
Address if requested to be mailed
Name _______________________________________________
Name ______________________________________________
Address _____________________________________________
Address ____________________________________________
City ____________________ State ______ Zip ___________
City ____________________ State ______ Zip ___________
Authorization Statement and Signature
I certify, under penalties of perjury, pursuant to Florida Statute Section 92.525, that I am the former student requesting my
records , or the parent/guardian of a former student (who is under the age of 18 or meets other statutory requirements )
requesting records of said student. I hereby authorize the release of records of information requested.
Signature: ________________________________________________________________
Date: _______________________
Eligible Parent/Legal Guardian or Student 18 Years of Age or Older
REMARKS: ________________________________________________________________________________________________
CSC Rep: ________________________________
Receipt # ________________________________
Date Mailed/Picked Up _____________________
Check # _________________________________

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Student Transcript Request Form - Campuses - Kaplan University Student Transcript Request Form - Campuses - Kaplan University Business
High School Former Student Transcript Request Form High School Former Student Transcript Request Form Business
Transcript Request Form Students - University Of Saskatchewan Transcript Request Form Students - University Of Saskatchewan Business
Transcript Request Form (for Current Students On The Affiliated Program) - University Of The Southern Caribbean Transcript Request Form (for Current Students On The Affiliated Program) - University Of The Southern Caribbean Business
Transcript Request Form (former Student) - Harvard High School Transcript Request Form (former Student) - Harvard High School Business
International Transcript Request Form For Students Educated Outside The U.s. International Transcript Request Form For Students Educated Outside The U.s. Business
Office Of Student Records Transcript Request Form Office Of Student Records Transcript Request Form Business
Georgia Cyber Academy High School Student Transcript Request/release Form Georgia Cyber Academy High School Student Transcript Request/release Form Business
Request Form For Official Student Transcript/records From Closed Proprietary Schools Request Form For Official Student Transcript/records From Closed Proprietary Schools Education
Form Ga-697-811 - Official Transcript Request - Online And Off-campus Students - Florida Institute Of Technology Form Ga-697-811 - Official Transcript Request - Online And Off-campus Students - Florida Institute Of Technology Business

Related Categories

Parent category: Business
Download
Go