Revised 08/2017
Request to Mail Diploma
Office of the Registrar / 200 West Kawili St. Hilo, HI 96720-4091 / Student Services Center, First Floor Rm 101 / Phone: (808) 932-7447 / Fax: (808) 932-7448 / E-mail: uhhro@hawaii.edu
Diploma will not be released if student has any financial obligations
SECTION I: Student Information
Name: _________________________________________________________________ Student ID: _____________________________
Last First MI
Degree Conferral: Semester/Month: ______________________________ Year: _____________
SECTION II: Check all items to be mailed and list major/subject/program:
BA Major: _______________________________________________________________________________________________________
BS Major: _______________________________________________________________________________________________________
BBA Major: ______________________________________________________________________________________________________
Certificate Program: ________________________________________________________________________________________________
Master’s Program: ________________________________________________________________________________________________
Doctoral Program: ________________________________________________________________________________________________
SECTION III: Mailing/Contact Information:
Name: __________________________________________________________________________________________________________________
Address: ________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
City: ________________________________ State: __________________ Nation: ______________ Zip Code: ______________________
Telephone: _________________________________________ Email: _________________________________________________________
Signature: _______________________________________________________________________ Date: ___________________________
FOR OFFICE OF THE REGISTRAR USE ONLY:
SOAHOLD Mailing date: __________________ Diploma Covers: _________ SHADIPL Date: ___________________
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