Park University Duplicate or Replacement Diploma Order

I f you would like to order additional Park University diplomas (post graduation) please place your order through the Office of Alumni Relations. These diplomas will bear the signature of the current University President and current chairman of the board of trustees. To order the new diploma, please complete the form below and submit $75.00 to:

Office of Alumni Relations

Park University 8700 NW River Park Drive

Parkville, MO 64152

Name Printed on Original Diploma: __________________________________________________Year of Graduation: _________ Please send a photocopy of the original diploma if possible. If requesting a diploma in a different name, please provide proof of legal name change.

Current Name: _____________________________________________________________________________

Mailing Address: ___________________________________________________________________________

___________________________________________________________________________

Email : _______________________________________ Phone: _________________________________

Payment Method: Check or Credit Card: Visa Mastercard Am Exp Discover

Card #: _____________________________________________ Expiration Date: ______________________

Name on credit card: _______________________________________________________________________

Signature: ________________________________________________________________ Date: __________

Diplomas may take up to 90 days to produce.

Proceeds support the Marlowe Sherwood Memorial Scholarship Fund— the Park University Alumni Association’s Legacy Scholarship

the scholarship created by alumni for alumni

Name to be Printed on Diploma: ______________________________________________________ Park ID #:

CID #: