STUDENT INFO
Please provide me with a copy of my student records or information about my enrollment at Berkshire Community College as indicated below:
Student Name
LAST FIRST M FORMER
Student ID
Signature Date
The following items can normally be made available while you wait:
Transcript - Unofcial
Final Grade Report for the semester
Student Class Schedule for the semester
The following items normally require a 24-hour notice:
Verication of enrollment for the semester
Completion of the attached form (i.e., student loan deferment, verication for insurance) for the semester
Other information (please describe):
Section 30 Form* (Pickup Only). Contact phone number:
*This may take up to two weeks to complete.
For items requiring a 24-hour notice:
I will pick up the completed information.
Please fax my request to the following:
Agency or Person Fax #
Please email my request to:
Please mail my request to:
Request for Student Info
OFFICE OF THE REGISTRAR (Please type or print)
Berkshire Community College ▪ 1350 West Street, Pittseld, MA 01201 ▪ www.berkshirecc.edu ▪ 413-499-4660 
Revised 4/13/2020
OFFICE USE ONLY
Request completed by Date
click to sign
signature
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