Brooklyn Technical High School

• # of Transcripts Needed (@ $10.00 per copy) 01234
• # of Proof of Graduation Letters Needed (@ $5.00 per copy) 01234

Fields marked with an * are required

1. Today's Date*
2. Last Name*
3. First Name*
4. Maiden Name (if applicable)
5. Address *
6. City *
7. State *
8. Zip Code *
9. Date of Birth *
10. Social Security # *
11. OSIS #
12. I Graduated (mm/yyyy)
13. I DID NOT Graduate and was discharged (mm/yyyy)
14. Email*
15. Comments

Please send the Official Transcript(s) or Proof of Graduation Letter(s) to the following address(es)

1. Address #1
2. Name:
3. Address:
4. City
5. State
6. Zip

1. Address #2
2. Name:
3. Address:
4. City
5. State
6. Zip

1. Address #3
2. Name:
3. Address:
4. City
5. State
6. Zip

1. Address #4
2. Name:
3. Address:
4. City
5. State
6. Zip