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There is a $15.00 non-refundable fee which includes (University of Hawaii at Hilo)

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Office of the Registrar / 200 West Kawili St. Hilo, HI 96720-4091 / Student Services Center, First Floor Rm 101 / Phone: (808) 932-7447 / Fax: (808) 932-7448 / E-mail: uhhro@hawaii.edu
• There is a $15.00 non-refundable fee which includes one diploma in both English and Hawaiian per certificate/degree
requested. Only one diploma cover provided.
• Submit completed form with non-refundable processing fee to the UH Hilo Cashier’s Office
• Please note that we may not be able to provide an exact replication of your original diploma
• Replacement diplomas will have the word “DUPLICATE” engraved on them. Replacement diplomas are diplomas ordered
outside/after your graduation semester.
• Additional diplomas are additional copies of your diploma ordered during your graduation semester
• See
http://hilo.hawaii.edu/registrar/GraduationInfo.php#OfficialDiploma for diploma distribution dates
• The name that will be printed on the Replacement/Additional diploma will be the name under which you completed your
degree requirements. You may order your Replacement/Additional diploma with your new legal name, provided that you
submit the Change of Name/Preferred Name Request Form along with two legal documents stating the name change. Form
is available online at https://hilo.hawaii.edu/registrar/documents/UHNameChange-PreferredNameForm.pdf.
• Hawaiian language diplomas are available for ordering effective Spring 1995.
SECTON I: Type and Amount of Diploma(s) Requesting:
Degree
Major
(List Major)
Enter Quantity of
Diploma Requesting
Below
English Hawaiian
Unit Price
($15 per diploma)
Total Amount
(Diploma Quantity x Unit
Price)
BA $15.00
BS $15.00
BBA $15.00
Certificate
Program $15.00
Master's
Program
$15.00
Doctoral
Program $15.00
Total Cost:
Graduation Semester: Fall Spring Summer Year: 20_____
Please mail diploma to the mailing address below:
SECTION II: Student Information
Name: _______________________________________________________ Student ID Number: _____________________________
Address:_____________________________________________________________________________________________________
____________________________________________________________________________________________________________
City:____________________ State: ______________ Zip Code: __________________ Nation: _______________
Telephone Number: (_____) _______________________ Email Address: ___________________________________________
Signature: ______________________________________________________ Date: ________________________
FOR OFFICE OF THE REGISTRAR USE ONLY:
SOAHOLD SHADGMQ SHADIPL Log Initials: Date:
Revised 7/2019
REQUEST FOR REPLACEMENT/ADDITIONAL DIPLOMAS
FOR CASHIER’S OFFICE USE ONLY: Cashier: ____________
Amount Paid: __________ Date Paid: ______________
VISA / MC / CC Other / MO / Cash / Check #:________
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Completed 29 August 2020

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