Diploma Reprint Request Form

Diploma Reprint Request Form

Disclosure

Requests cannot be processed without requisite documentation. We are unable to print a replacement diploma for anyone other than the graduate. The cost for a replacement diploma or certificate is $25.00. You will be asked to make a payment if you request a physical diploma. Your diploma will not be released until payment is submitted.

Please be sure to have two forms of identification ready. At the end of this form you will be asked to add the PDF as an attachment.

Note: Digital diplomas do not require purchase.

I understand that the office of the Registrar at PCOM will not process this request without 1) this form fully completed and 2) two (2) valid forms of identification.*

Is this request to provide proof of your graduation for a place of work and only require a digital copy?*

Select

Type*

Select

I understand that the office of the Registrar at PCOM will no process this request without submitting a $25.00 online payment.*

Personal Information

First Name*

Last Name*

Name When Attending

Banner ID/SSN

Date of Birth*

Campus*

Select

Degree*

Select

Program*

Select or enter value

Phone Number*

Phone

Email Address*

Delivery Information

Full Name to Appear on Diploma*

Delivery Options*

Select or enter value

Email Address (multiple if needed)*

Recipient Street Address*

Recipient City*

Recipient State*

Select

Recipient ZIP Code*

Forms of Identification*

Select

Pick Up

You will be notified when you are able to pick your diploma. It will be located at:

PCOM

Rowland Suite 203

Registrar Office

4190 City Avenue

Philadelphia, PA 19131

Attach Document

Please attach the two (2) vald forms of identification here. Your request cannot be processed until those two documents are submitted.

File Upload*

Drag and drop files here or

Payment

Please be sure to submit your payment of $25.00 to:

PCOM

Registrar Office

4190 City Avenue

Philadelphia, PA 19131

Please send your check with your name and graduation year.

Order Number

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