Duplicate Diploma Request
Fax: (316) 295-5072
Student Information
Name:
Last
First MI
Friends University ID:
Address:
City State Zip
Phone: Email:
Date of Birth: Previous Name(s):
Degree: Year Awarded:
Major: Honors:
Name exactly as it should appear on diploma:
Agreement
Student Signature: Date:
Payment Information
Revised: January 14, 2020
If you do not know your ID #, leave blank and complete date of birth below.
A Fee of $35.00 per diploma is required prior to processing.
FOR OFFICE USE ONLY
FEE: ___________ Due: ___________ Paid: ___________ Student Account Services
Ticket #: ___________________________________________________ Sent: __________________________
Please Complete Form Entirely to Avoid Processing Delays
St
udents may pay in person at the Cashier Window or over the phone by contacting the Cashier at (316) 295-5865.
Please have payment information ready at the time of call.
click to sign
signature
click to edit
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