Request for Official Transcript of Records

Student Name*

First NameLast Name

Student ID Number

Year of Matriculation

Are you a UHSA graduate?*

YesNo

Year of Graduation*

Upload an image of your diploma for identification purposes*

Purpose of transcript request

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Where would you like your transcripts sent?

Order Transcripts*

Official Transcript RequestThe initial copy of transcripts is $75. All items are shipped via first-class mail. If you require expedited shipping that has a tracking number, please visit https://form.jotform.com/211793528448869

$75.00 Quantity

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature*

I acknowledge and agree that the University of Health Sciences Antigua will not release official transcripts, enrollment verifications, ECFMG or other third-party verifications, letters of recommendation, or any academic records if my student account has any outstanding financial balance.

I understand and agree that all financial obligations to the University must be paid in full before any such documents or verifications will be processed or released.

I acknowledge and agree that any payments made in connection with this form submission are final, non-refundable, and non-creditable for any reason.

This acknowledgement forms part of my official student record with the University.

By submitting this form, I confirm my understanding of and agreement to this policy.

Financial Clearance Acknowledgement*

I have read, understood, and agree to the Financial Clearance Policy above.