Fillable Replacement Diploma Request Form (Utica College)

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Replacement Diploma Request Form (Utica College)

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The Replacement Diploma Request Form (Utica College) form is 1 page long and contains:

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  • 11 check-boxes
  • 11 other fields

Country of origin: US
File type: PDF

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Replacement Diploma Request
Once completed, you may mail, fax, or
scan/e-mail this form to our office.
Mail/Courier:
Office of the Registrar
1600 Burrstone Rd; 123 White Hall
Utica, New York 13502
Phone:
315-792-3393
Fax:
315-792-3020
e-mail:
registrar@utica.edu
Current Name:
Student ID# (if known):
Name EXACTLY as you wish it printed on diploma:
Diploma name must comply with our Diploma Name Policy, which is published online:
https://www.utica.edu/academic/registrar/diplomaname.cfm
Date of Birth:
Date of Graduation:
Graduation status will be confirmed before the diploma will be
ordered.
E-mail address:
Your Current Mailing Address: Street/PO Box:
City, State, and ZIP:
Country (if not in the US):
If you wish your diploma to be sent to a different
address, please enter it here: Street/PO Box:
City, State, and ZIP:
Country (if not in the US):
Be sure that all addresses entered are complete. Utica College is not responsible for delivery problems due to incomplete or
insufficient addresses. If selecting Platinum service, the diploma will be sent via UPS and cannot be delivered to a PO Box.
Delivery Method
FEE (all fees in US$)
Delivery time
(approximate)
Postal Mail
$25.00
Varies
Postal Mail
$40.00
2-3 weeks
UPS (www.ups.com)
$80.00
1 week
UPS (www.ups.com)
TO BE DETERMINED
Depends upon
delivery address.
Payment
Information
Cash Check Money Order Visa MasterCard American Express Discover
(Make checks and money orders payable to Utica College)
Credit Card #:
Exp. Date:
CVV code**:
** We cannot process a credit card without this code.
SIGNATURE OF ALUMNUS:
(“electronic” signatures not accepted.)
NOTES:
If you have a hold on your account, we cannot issue a replacement diploma.
Replacement diplomas will be marked at the bottom with "Replacement" in about a 10-point font and the date the
document was printed.
Replacement diplomas will be in the current style of newly-issued Utica College diplomas with current signatures.
Form updated: 17 October 2014
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Replacement Diploma Request Form (Utica College)

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Completed 16 August 2020

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