Academic Transcript Request Form

Academic Transcript Request Form

Please fill out the form below to request your academic transcript.
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Student ID Number
Current Semester*
Program of Study*
Email Address*
example@example.com
Phone Number*

Area CodePhone Number
Graduation Year
Delivery Method*

Pick up in personMail to addressEmail (PDF)
Mailing Address (if applicable)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Payment Information*

Credit/Debit Card (you will be contacted by our accounts department for securepayment processing)Wire TransferPaypal/Wise
Additional Notes
Student Authorization*

I hereby authorize John F. Kennedy University School of Medicine to release my officialtranscript as indicated above.
John F. Kennedy University School of Medicine provides official transcripts of academic records upon written request from the student. A non-refundable fee of US $75 per transcript is required. Please complete all sections of this form clearly. Incomplete information may delay processing.
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