Certificate Requirements Checklist Full Name (as you'd like written on your certificate) Full Name (as you'd like written on your certificate) First First Middle Middle Last Last Email * Post-graduation email address Address * Post-graduation mailing address Address Line 2 City * State * ALAKARAZCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Postal Code * MHSL ID Number * What type of student are you? Day Evening Weekend Hybrid Online Working Professional Which certificate(s) did you complete? * J.D. Health Law Certificate J.D. Health Care Compliance Certificate Online Health Care Compliance Certificate for Working Professionals If you are human, leave this field blank.
