Duplicate Diploma Request Form

Payment via credit card expected after submission of this form. Please have your credit card ready.

ONLY for Texas Tech K-12 Students

Note:
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* Required

STUDENT INFORMATION

Name (on original diploma)

Requested (new) Diploma Name (if applicable)

Birth Date

Year Diploma Awarded

Mail Diploma to Name

Current Mailing Address Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone

E-mail Address

ORDER INFORMATION

Number of Diplomas ($25.00 each)

Expedited Shipping YES ($30.00 each)

Questions? Contact Texas Tech K-12.

ONLY for Texas Tech K-12 Students
NO REFUND after REQUEST MADE

By clicking submit, you are electronically authorizing this Duplicate Diploma Request Form to be submitted.