Request for Replacement Diploma

"*" indicates required fields

Surname*

First Name*

Additional Names

Former Name

Student #*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

No P.O. Box if sending by courier

Daytime Phone

Alternate Phone

Email*

Degree Awarded*

Year of Graduation*

Reason for Replacement

Choice of Delivery*

I will personally pick up the diploma

Courier to address provided above

I will authorize another person to pick up my diploma

Full Name of the Person pickup up the diploma*

Proof of ID will be required

Signature of Graduate*

Original signature mandatory

Replacement diplomas are issued at the same time of the current year’s Convocation (November).
Replacement diploma will bear signatures of the current officials.
A reissue date will be printed at the bottom of the replacement diploma.
Please note that the diploma reissued will bear the same name as per the student record in the University’s Repository of Student Information (ROSI) system. If you require a name change, please also submit the Change of Name Request form.

Replacement Diploma Fee*

Price:

Courier within Canada

Price:

Courier to the U.S.

Price:

Courier to overseas / international destination

Price:

Total