Diploma Reprint Request

Below you may request your diploma to be reprinted and mailed by the Registrar's Office. The charge is $50. Please provide your information below. You should receive your diploma in the mail within 2-3 weeks.

First Name (as it was when attending Belhaven)*
Last Name (as it was when attending Belhaven)*
Email Address *
Phone Number *
Degree/certificate Earned *
Approximate date degree/certificate completed (format: mm/dd/yyyy) *
Date of Birth (format: mm/dd/yyyy) *
Last 4 of SSN *
Mailing Street Address *
City *
State *
Zip *
Special instructions (i.e., notary required, multiple degrees/certificates, etc.):
Payment Method *
Credit Card

Amount *