IMPORTANT: this form is only for students who have completed the Off the Beaten Track program and finished either their poster assignment and/or research paper.

(or student number, in your home university)

(usually the date of your first registration as a student in your home university)

(please write month in full, eg. March 29, 1995)

Name of the administrator or department in charge of your credits

Exact address to where and who the transcript should be sent to.