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Request Transcript

Name: Request Transcript
Published: 2019-06-23T03:47:08+00:00

First Name*
Last Name*
Program:*
- Radiologic Technology
- Radiation Therapy
- Sonography
- School of Nursing
Year of Graduation:*
Social Security # (last four digits only):*
Mailing Address:*
Street Address City State ZIP Code
Email:*
Phone:*
Release Type:*
By completing this form I give Grady Schools of Radiation and Imaging Technologies authorization to release my Academic Records to the following:
- Myself
- School/ College/ Organization
Send Transcript To:*
Street Address Address Line 2 City State ZIP Code
Transcript: Quantity*
Price: $5.00
Non Refundable
Total
$0.00
Credit Card*
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