Spokane Community College
REPLACEMENT DIPLOMA ORDER FORM
Submit Completed form to:
SCC Transcript Office
1810 N Greene St MS 2151
Spokane WA 99217
Email: Transcripts@scc.spokane.edu
Fax: 509-533-8887
$25 fee charged per diploma
Minimum 6 week processing
Payment required prior to processing
DIPLOMA INFORMATION
Print (use black or blue ink) your name exactly as it should appear on your diploma.
ILLEGIBLE FORMS WILL BE R ETURNED
First Name: Middle Name or Initia l
Last Nam e :
Mail my diploma:
Address :
C i t y:
S t a t e: Z I P:
Phon e :
E-m ail:
Student Identification Numb er: (f o r mat: ###-###-###)
Completion Year and Quarte r :
Name of Degree or Certificate Ear ne d
I hereby certify that to the best of my knowledge all of the above information is correct.
I understand it is my responsibility to return this completed form to the SCC Transcript Office and advise
the Transcript Office of my diploma mailing address change.
Student Signature (REQUIRED):
Date:
COMPLETE FOR MAIL AND FAX REQUEST ONLY
Indicate method of payment – DO NOT SEND CASH
Check Enclosed Charge my
: V
Card holder’s name (please print)
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