Diploma Replacement Form

Diploma Replacement Form
This request form must be completed by the GRADUATE or ALUMNI. This form will not be processed without the electronic signature of the graduate for whom the diploma was granted. Your diploma will be ordered upon receipt of the completed form. **Please be advised that a replacement diploma will be send with the current university seal and diploma format.

Students who graduated in December 2022 or later may access their diploma at https://www.parchment.com/u/auth/login.
Belmont University is the Custodian of Records for O'More College of Design and Watkins College of Art.
Select Degree Granting Institution.*

Belmont UniversityO'More College of DesignWatkins College of Art
Graduate's Name (on academic record)*

First NameMiddle NameLast Name
Student ID Number*
If you do not know your student ID, please enter your date of birth
Date of Birth*

MonthDayYear
Date
Delivery Email Address*

Confirmation Email
Phone Number*

Area CodePhone Number
Delivery SMS Number*
Phone Number with no spaces
Diploma Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Graduation*
Students who graduated in December 2022 or later may access their electronic diploma at https://www.parchment.com/u/auth/login.
Diploma Name (to be printed on the diploma)*
Your name exactly as you would like it to appear on the diploma
Degree Earned*
example: Bachelor of Science
Honors Earned (if applicable)*

Summa Cum LaudeMagna Cum LaudeCum LaudeNone
Choose one of the following diploma options*

Electronic Diploma = $5Hard Copy and Electronic Diploma = $35
Do you need an Apostille?

(a form of authentication issued to documents for use in other countries) *Please note: The addition of an Apostille can take up to 6 weeks for processing. Visit TN Secretary of State's website for more information:

https://sos.tn.gov/businesses/guides/apostille-authentication-guide
Do you need an apostille on your replacement Diploma? (Hard Copy of Diploma Required Above:

YesNo
Do you need an apostille on your official transcript included with the Diploma?

YesNo
Number
Purchase Price
ELECTRONIC SIGNATURE: Entering your name in this field will serve as your official signature of acknowledgement and approval*

First NameLast Name
Signature

Clear
Initials*

Credit Card purchase

USDDescription

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please verify that you are human*
Email
example@example.com
Should be Empty: