Replacement diploma form test

Duplicate/Replacement Diploma Request

Student ID

if known

Email(Required)

Phone

Date of Birth

Month(Required)

Day(Required)

Year(Required)

Your name

Full legal name while attending(Required)

First Middle Last

Name to be printed on diploma(Required)

Year Degree Awarded(Required)

Reason for requesting diploma(Required)

Address

Shipping address for the diploma(Required)

Note: We cannot send your diploma to a PO box.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Payment Option(Required)

The charge for a new diploma is $50.00. Pay by check/money order or online through our virtual terminal. Your request will be processed once payment is received.

Upon submission of this form, you will be forwarded to the Transylvania University virtual terminal to make payment.

Select Other Payments from the Payment Options drop down
Select the Make A Payment button
Complete the Make A Payment form. Enter $50.00 in the payment amount field

Submit this form and mail payment to:
Transylvania University
Office of the Registrar
300 N. Broadway
Lexington, KY 40508