Replacement of a Master’s Diploma Request Form
California State University, Chico
Office of Graduate Studies
Student Services Center, Room 460
To request replacement of a master’s diploma, return this completed form to the Office of
Graduate Studies with a check or money order for $12 for each diploma payable to CSU, Chico.
Bachelor’s diplomas can be ordered through Graduation Advising in the Office of the Registrar.
Student Name: _________________________________________________________________
Student Signature:
Name as it should appear on the diploma:
______________________________________________________________________________
Please note: If you are a former student and have had a name change, you must submit a
Student Information Update form listing your new name before requesting an updated
diploma. https://www.csuchico.edu/sro/_assets/documents/info-update-former.pdf
Chico State ID Number/Last 4 of SSN: ______________________________________________
Maiden Name: ______________________________ Email Address: ______________________
Date of graduation: Degree Earned: ______________________
Program/Option:
Mailing address:
City________________________ State________ Zip______________________
Country __________________________________________________________
Number of diplomas requested ___________
Mail or Submit to:
Office of Graduate Studies
Student Services Center, Room 460
California State University, Chico
Attention: Rosanne Kenoyer
Chico, CA 95929-0875
Please allow 6 weeks for replacement.
7/2019
Diploma Replacement Item Code 02005
