Revised: September 2016 Office of Records & Registration
ADDITIONAL DIPLOMA/CERTIFICATE REQUEST FORM
Golden Gate University issues one diploma upon graduation or one certificate upon completion of a certificate program. To
request an additional copy, fill out this form and submit with payment to: Golden Gate University, Office of Records and
Registration, 536 Mission Street, San Francisco, CA 94105-2968; or fax to 415-442-7223; or email scanned form to
graduation@ggu.edu.
• Rush orders will be sent within 3 business days and regular orders will be sent within 10 business days.
• We do not refund fees for cancelled requests.
• We do not release documents for students with unresolved financial obligations with the university. If we find an
obligation exists, the Office of Student Accounting Services will contact you. If you do not resolve the matter within 30
days, we will return your request, along with any payments you have submitted.
• If you have questions, call 415-442-7278 or email graduation@ggu.edu.
Name on GGU
Academic Record: ________________________________________________________________________________________
last (family/legal) name first (given) name middle name or initial
Name as You Would Like It
to Appear on Your Document: ________________________________________________________________________________
If you wish to have your document issued in a name that differs from the one the university has on record for you,
you must attach documentation verifying a legal name change, such as a photocopy of a marriage license, passport,
Social Security card or other legal document. The university will change your name in our records to reflect this new
name.
GGU ID or Social Security Number: _________________________________ Date of Birth: _____________________________
month /day/ year
Completion Date: _________________ Program Title: ___________________________________________________________
month /year
Hold for pick-up. Do not mail my diploma/certificate. Mail my diploma/certificate to the address below:
Address: _________________________________________________________________________________________________
street city state zip country
Daytime Phone: ________________________________ Email Address: ___________________________________________
Check all fees that apply:
Document Fee:
$50 Diploma/certificate suitable for framing or; $10 Notarized diploma for authentication outside the U.S.
Transcript Fee:
$15 Official notarized transcript to be included with notarized diploma
Rush Processing Fee:
$20 Domestic shipping $30 International shipping
Method of Payment
: Cash Check or Money Order (made out to “Golden Gate University”)
American Express Discover MasterCard Visa (enter credit card number below)
**If you prefer, you may provide your credit card information over the phone by calling 415-442-7278 after faxing this form.
Student Signature: ______________________________________ Date: ______________
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Cashier: Cut off bottom section of form and shred after processing payment.
Credit Card Number: _________________________________________________ Exp. Date (MM/YYYY): _________________
Date Sent: ___________
OK HOLD
Initials___________
click to sign
signature
click to edit
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