PLEASE CHECK ONE: ON-LINE APPLICATION___________________
BETHPAGE HIGH SCHOOL
TRANSCRIPT REQUEST FORM
Student Name Counselor Name
• This form must be submitted to Mrs. Wing with each application two weeks before college deadline
• Do not leave your application on the secretary’s or counselor’s desk.
Name of College/University_______________________________________________________________
Full Mailing Address_____________________________________________________________________
Type of Application and Deadline:
Early Decision_____ Early Action_____ Rolling Admission_____ Regular Decision_____
IT IS THE STUDENT’S RESPONSIBILITY TO KNOW THE COLLEGE’S DEADLINE DATE AND SUBMIT
THEIR APPLICATIONS TWO WEEKS PRIOR TO THIS DATE.
Kind of Application: Check one
Common Application____ Private School Application____ SUNY Application____ CUNY Application____
SUNY: list campus names________________________________________________________________
CUNY: list campus names_________________________________________________________________
I SENT MY SAT/ACT SCORES FROM THE COLLEGE BOARD OR ACT AGENCY. Yes______ No_______
Sign your name________________________________________________________________________
Checklist: Must be submitted prior to submitting applications to Counseling Center:
_____Application submitted and fee paid by: credit card___ check enclosed___ check #___
_____SECONDARY SCHOOL REPORT/COUNSELING FORM signed and attached (if applicable).
_____Teachers who are writing recommendations must be given a stamped/addressed envelope for each
college you have applied to. Allow teachers two weeks.
_____I have attached a 9 x 12 self-sealed envelope with three (.44) stamps to this form. The
envelope is addressed to the college’s admissions office with Bethpage H.S. as return address.
_____MID-YEAR REPORT (only if applicable) and an envelope addressed to college with Bethpage H.S.
return address. Business-sized envelope with one (.44) stamp. Student name written on inside flap.
_____I have met with my counselor for my fall senior conference prior to submitting my first application.
_____My Guidance Packet is complete.
_____________________________________ __________________________________ _______
Student Signature Parent Signature Date