Fillable Duplicate Diploma/Certificate Request (Norco College)

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Duplicate Diploma/Certificate Request (Norco College)

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10/13/16 3:34 PM
Duplicate Diploma/Certificate Request
Riverside Community College District
Print out the request form and pay at the cashier window to process or you may also mail form to the college with
check payable to RCCD at your college listed below. Requests will be ordered with the next regular order of diplomas
and certificates. It may take up to 6 months to receive the duplicate. Cost is $2 each.
Moreno Valley College
Admissions & Records
16130 Lasselle Street
Moreno Valley, CA 92551-2045
Norco College
Admissions & Records
2001 Third Street
Norco, CA 92860-2600
Riverside City College
Admissions & Records
4800 Magnolia Avenue
Riverside CA 92506-1299
____________________________ or ____________________________
Social Security Number Student ID#
Your LEGAL NAME as you want it to appear on diploma: This name must be on record at RCCD.
________________________________________________________________________________________
First Middle Last
Please indicate the year in which your degree/certificate was awarded: ____________________________________
Diploma/Certificate Mailing Address: CHANGES MUST BE REPORTED DIRECTLY TO THE EVAL/ GRAD OFFICE
______________________________________ ______________________________ _____ ____________
Number and Street Apt# City State Zip
(__________)____________________________________ (__________)_____________________________________
Home Phone Number Mobile Phone Number
Degree for which you are applying (CHECK ONE ONLY): AA Degree AS Degree Certificate
List Program of Study (Major) if known:
_____________________________________ or _____________________________________
Program of Study (Major) Certificate Program
Student Signature: ___________________________________________________ Date: _______________
FOR OFFICE USE
ONLY
Date Filed: ___________________
Receipt Number: ______________
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Duplicate DiplomaCertificate Request (Norco College)

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Completed 2 February 2021

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