(Your name will appear on your diploma as it does in our student information system records. If your name as changed since you graduated, you must complete a Name Change Request Form.)
OFFICE OF THE REGISTRAR
THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE
REQUEST FOR DUPLICATE DIPLOMA
Directions: Please print, complete and return to the Office of the Registrar.
Print Name as it should appear on your diploma:
(Your
name will appear on your diploma as it does in our student information
system records. If your name as changed since you graduated, you
must complete a Name Change Request Form.)
Name
at time of Graduation
Graduation
Date:
Address
Diploma is to be mailed to:
What
is your Major:
Type of Degree
|
(BA) Bachelor of Arts |
|
(BM) Bachelor of Music |
|
(BS) Bachelor of Science |
|
(BSN) Bachelor of Science in Nursing |
|
(BSW) Bachelor of Social Work |
|
(MA) Master of Arts |
|
(MS) Master of Science |
|
(MAE) Master of Arts in Education |
|
(MBA) Masters in Business Administration |
|
(MPA) Masters in Public Administration |
|
(MSA) Master of School Administration |
Honors Received
|
Summa Cum Laude |
|
Magna Cum Laude |
|
Cum Laude |
|
University Honors College |
|
Chancellor's Scholar |
Applicant's
Signature: Date:
Cashier's
Signature: Date:
| Receipt
Number: |
|
| Fees: | PLEASE
RETURN THIS FORM TO THE OFFICE OF THE REGISTRAR |
$25.00
for Duplicate Diploma |
|
$10.00 for
Diploma Cover...... |
|
Please return completed form to:
Office of the Registrar
PO Box 1510
Pembroke, NC 28372-1510Office Location: Lumbee Hall, Room 133
Return to Forms | Office of the Registrar