Certificate and Transcript Request Form

Continuing Education Certificate Reprints

Professional continuing education certificates are made available online at the end of each program. You must have an enrollment key and complete a course evaluation to access your certificate. Please make every effort to save and/or print your certificate and keep it in a safe place. There is a $25.00 charge for a duplicate certificate. Payment must be received before request can be processed.

Transcript Requests

Continuing education transcripts are available upon request. There is a $25.00 charge for a transcript request. Payment must be received before transcript request can be processed.

Name*
FirstLast
Permanent Address*
Street AddressAddress Line 2CityStateZip Code
Phone*
Email*
Place of Employment
Class Name*
Class Date*

You may also print this form out and send it to us with your check to:
Upstate AHEC – 200 North Main Street – Greenville, SC 29601
Fax: 864-349-1179 – 24 hours a day
e-mail: tpierce@upstateahec.org