Duplicate Diploma Request

Bachelor, Master and Specialist duplicate diplomas are $30.
Doctoral duplicate diplomas are $60.

Today's Date Today's Date / MM / DD YYYY
Student's Full Name Student's Full Name First Middle Last
Previous Name (If Applicable)
Email
Phone Number Phone Number - ### - ### ####
Student ID or SSN
(Example: 123456 or 123-45-6789)
Name of Degree
Term or Month and Year Degree was Awarded
I would like to

I would like to have my duplicate diploma mailed to me. (Cost will be extra for shipping if mailed outside of USA) pick up my duplicate diploma have someone else pick up my duplicate diploma for me (ID Required)
Mailing Address Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Payment Information
(Payment is NOT automatic.)

Bachelor, Master and Specialist duplicate diplomas are $30.
Doctoral duplicate diplomas are $60.

Student accounts must be free of holds before payment is processed.
Credit/ Debit Card Type

Credit/ Debit Card Type Discover Mastercard Visa
Card Number
Expiration Date
(MM/YYYY)
Please read before submitting request.
Once a request has been received, the Registrar's Office will check for any academic or financial HOLDS on the student's records. If HOLDS exist, (1) the student will be notified by email, (2) the Duplicate Diploma request will be VOIDED (3) fees will not be charged. Duplicate Diploma requests will need to be submitted again after all HOLDS are cleared. _______________________________________________ AGREEMENT I understand that all HOLDS must be cleared and payment provided before the request is processed. If issues are not cleared, I will be notified, and I must resubmit my request.
Signature Required

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

Duplicate Diploma Request

Duplicate Diploma Request

Payment Information (Payment is NOT automatic.)

Payment Information
(Payment is NOT automatic.)