Duplicate Degree/Certificate Request
A $10.00 processing fee is assessed for a duplicate copy of your degree and/or certificate. To request a
duplicate degree, please complete this form and submit the form and the $10.00 processing fee to the
Admissions and Records Office. All requests must be either mailed with payment (check or money
order) or submit this request in person to the Admissions and Records Office. If you are mailing your
request, please attach a copy of your picture ID. The processing time is two to three weeks. Please
make all checks payable to Moorpark College.
Please Note: All duplicate degrees and certificates will include the word duplicate. Any
outstanding fees and/or holds need to be cleared prior to submitting this request.
Student’s Name __________________________________________________________________
(Please print) Last First Middle Initial
Student ID/SSN ________________________ D.O.B._______________________
Phone
number: ___________________________
Address ________________________________________________________________________
_______________________________________________________________________________
City State Zip Code
Type of request: Degree (AA/AS) Certificate of Achievement
Major: ________________________________________________________
Semester received: _____________________________
Once ready, do you want the degree/certificate: Mailed I will pick up (2 to 3 Weeks)
Signature __________________________________ Date _______________________
-------------------------------------------------------------------------------------------------------------------------------------------------------
------For Office Use Only------
Received by _____________ Date_________________
Date Processed ______________
Moorpark College
