Fillable Duplicate Diploma Form Office of Records & Registration (University of Wisconsin - LaCrosse)

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Duplicate Diploma Form Office of Records & Registration (University of Wisconsin - LaCrosse)

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Duplicate Diploma Form
Office of Records & Registration
Duplicate diplomas will be available approximately 1-2 weeks a
fter the order is
received. UWL charges a $25 fee per diploma.
First & Last Name:
Date of birth (mm/dd/yyyy):
(we’ll contact you if we have questions)
Name as you wish it to appear
on your d
iploma (please print):
Mailing Address for Diploma:
_______________________
___________________________________________________
Signature
Date
Mail completed form & check
(payable to UW- La Crosse) to:
UW- La Crosse Records & Registration
Attn: Duplicate Diploma
117 Graff Main Hall
1725 State St
La Crosse, WI 54601
ID Number (student ID or SSN):
Degree Received:
Date awarded (month/year):
Contact Information:
Questions?
records@uwlax.edu
608.785.8576
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Duplicate Diploma Form Office of Records & Registration (University of Wisconsin - LaCrosse)

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Completed 24 July 2020

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