Degree Parchment Re-Issue Order Form
This form must be completed in full by the individual who owns the academic record and submitted with proper payment
Enrolment Services,
Office of Registrarial Services,
U.C. Level 3, University of Guelph,
Guelph ON N1G 2W1
FAX 519-763-6809
The fee for this service is $28.25 per copy (includes HST). Please indicate the number of copies required ____.
A. Personal Information
Last Name:
First Name(s):
ID Number:
Date of Birth:
B. Graduation Information
Degree/Diploma obtained (I.E Bachelor of Science):
Date of Graduation Ceremony:
College Graduated From (I.E Arts):
Honours or General Program:
Exact way name is to appear on the parchment***:
***Note: If your name has changed since graduation and you wish to have this new name appear on your parchment re-
issue, or you want to have a middle name(s) added to it, you must provide legal documentation with this form (i.e.
marriage certificate, legally notarized proof of name change, birth certificate, passport etc.).
Page 1 of 3
click to sign
click to edit
C. Mailing Information
Street Address:
Apartment #:
Postal Code/ Zip Code:
Home telephone #:
Method of Shipping
(Additional Charges Will Apply)
Mail (included in the cost)
Courier (Ontario)
Courier (U.S.A)
Pick Up
Courier (Canada)
Courier (International)
Fax# (Parchment will then be mailed)
D. If paying by credit card, payment signature is required
Visa or Master Card holders signature:
Office Use
Date Request was received:
Date Parchment was processed:
Date Mailed:
Amount Received:
Receipt Number:
Page 2 of 3
click to sign
click to edit
Payment Information
Please indicate if payment will be through Visa or Master Card.
Master Card
Credit card #: / / /
Expiry (mm/yy): /
Card holders name:
The card holders signature is required on page 2.
Payment information will be destroyed upon successful payment process.
Courier fees:
Ontario - $15.00
All other provinces - $30.00
U.S Cities - $35.00
International - $40.00
Fax fees:
Ontario - $5.00
All other provinces - $5.00
U.S Cities - $5.00
International - $10.00
Purolator and Federal Express courier services will not deliver to a P.O. Box or Rural Route. It is the students
responsibility to provide a complete and accurate mailing address when ordering parchments.
Page 3 of 3
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome