Transcript Request

Your transcript request will not be processed until this form is submitted to the Registration Office. Requests submitted while you are actively enrolled in courses may be held until the current session concludes. If you have withdrawn from all courses during a session, transcripts will be issued reflecting your academic record as of the withdrawal date.

Date(Required)

Time(Required)

:

Student Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Current Address(Required)

Street Address Address Line 2 City State ZIP Code

Please select the reason(s) below

Request for

Transcript only

Reorder a duplicate ZHI diploma ($12 fee + shipping)

Letter of Enrollment Verification

Other

Course Information

Class

Method of Delivery (check one)

Message(Required)

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Signature(Required)

By signing this form, you are authorizing Zandu Health Initiative to release the information specified above.