Duplicate Diploma Order Form

The duplicate diploma you order will be identical in style and size as the diploma you were awarded when you graduated—no other options are available.

Name to appear on diploma	.
Name at graduation	.
Social Security Number	.
Degree received	.
Date of graduation (mm/yy)	.
Email contact
Day phone contact number
Diploma mailing address:



.
Student signature (required)
Date of request:

Print form, type or clearly print all information, sign, then mail along with $35.00 check payable to Western Michigan University to:

Auditing Office.
Office of the Registrar
Western Michigan University
Kalamazoo MI 49008-5256

For Office Use Only:
Fee paid

For Office Use Only:
Fee not required

For Office Use Only:
Waiting for payment