Duplicate Diploma Order Form PDF

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University of Montevallo
Registrar's Office
75 College Drive
Station 6040
Montevallo, AL 35115
registrar@montevallo.edu
Telephone: (205) 665-6040
Fax: (205) 665-6042

DUPLICATE DIPLOMA ORDER FORM

Duplicate Diplomas will be reprinted with your name as listed on your UM student record.
Note: Contact the Registrar’s Office for questions regarding changing your name of record.
Duplicate Diplomas will feature the names and signatures of current University administration.
Duplicate Diplomas will not be issued to anyone other than the alumni listed below.
Duplicate Diplomas will not be issued to anyone with outstanding financial obligations to UM.
Duplicate Diploma fee is $35.00 per diploma and payment must be submitted with this request.
Payment by check/money order should be made to the University of Montevallo, at the address listed above.

Student UMID:

Full Name while attending:

Graduation Date:

Honors:

Degree Earned:

Major:

College:

Mailing Address Line 1:

Mailing Address Line 2:

City:

State:

Zip:

Email Address:

Phone Number:

Check/Money Order $:

Comments:

This form requires the student’s signature.
Print PDF form then sign and date.

Student Signature: ______________________________________________________________

Date:_______________________

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