Transcript/Immunization Request Form

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Transcript/Immunization Request Form - ALJ Graduates

Alumni Transcript/Immunization request: If you have graduated from ALJ and require a Transcript/Immunization Record for a college application or employment verification, please use this form. Please allow up to 10 business days for all requests. Requests are fulfilled through the school counseling office at ALJ.

Email *

Record my email address with my response

Email *

Last Name *

Maiden Name or Last Name while attending ALJ

First Name *

Graduation Year *

Are you requesting a Transcript, Health Records, or Both?
*

Transcript

Health Records

Both - Transcript and Health Records

Birth date *

YYYY

Address and town while attending ALJ *

Name of College/Employer/Personal Use *

Address of Admissions Office or Employer (Where transcript will be sent) *

Contact number if we have questions *

Contact email if we have questions *

Please type in your name as your electronic signature to authorize the request *

Please type the date of request *

YYYY

Additional Notes (Optional)

Send me a copy of my responses.

Submit

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