Transcript Request Form
Ben L. Smith High School
2407 South Holden Road
Greensboro, NC 27407
Phone (336) 294-7300
Fax (336) 294-7313


Today's Date: _____________________________________

Name as it appears on the transcript: ___________________________________

Date of Birth: ____________/____________/____________

What year did you graduate? ______________

If you did not graduate, what is the last year that you attended Smith ________

Did you withdraw and enroll in another Guilford County school? _________________

If yes, what school did you attend? _________________________

Phone number where you may be reached: ________________________

Pick up? ___________yes ___________no

If no, where would like the transcript mailed?

Mailing Address: _________________________________________________
_______________________________________________________________

Your signature: _______________________________________________________

Parent signature if a minor: ______________________________________________
A picture ID must be shown for pick up!
You must be at least 18 years old.
A parent signature is required if you are under 18 years old.
Please note: A birth certificate will not be given to any child under age 18.

****Please note that this is a 7-10 business day process. ****
Thank you for your patience!SchoolCenter Picture