Diploma Replacement Form

Diploma Replacement Form

*This form may also be used to request the notarization of a diploma for an apostille or authentication request.
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. If you need a printed diploma, please continue to complete the form.
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. If you need a printed diploma, please continue to complete the form.
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 or Diploma Authentication?

An apostille is a form of authentication issued to documents for use in other countries. Belmont, Watkins, or O'More alumni who plan to work or further their education abroad may be required to authenticate any degree and/ or transcript through a process known as Apostille Certification. Visit TN Secretary of State's website for more information: Tennessee Secretary of State: Apostille & Authentication Guide.

*Please note: The addition of an Apostille can take up to 6 weeks for processing.
Do you need an Apostille or Diploma Authorization? (Hard Copy of Diploma Required Above:

YesNo
Tennessee Secretary of State: Apostille & Authentication Guide.

The following steps are required to complete the Apostille or Authentication Process:
- Step 1: Request or aquire acceptable documents such as a diploma or transcript
  - Completed by: student
- Step 2: Have the document notarized by a Tennessee Notary Public
  - Completed by: Belmont University
- Step 3: Take or mail the notarized document to the County Clerk of the County where the Notary Public was commissioned and have the Notary Public’s signature certified by the County Clerk.
  - If mailed, completed by: Belmont University.
  - If picked-up completed by: student or authorized individual.
- Step 4: Complete the Apostille or Authentication Request Form (ss-4504).
  - Completed by: student or authorized individual
- Step 5: Submit the request form, the public document, the county of certification and payment of the processing fee Office of Authentications Tennessee Secretary of State.
  - Completed by: student or authorized individual
Do you need your diploma notarized for an Apostille or Diploma Authentication? (Hard Copy of Diploma Required Above:

YesNo
Do you need your official transcript notarized and included with the Diploma?

YesNo
I understand that Belmont University can only provide the acceptable documents including the diploma and/ or transcript and notarize these documents.

Yes
Document Delivery:

Option 1: I would like my documents mailed to the County Clerks Office (Step 3) then to the address above. I understand that the County Clerks Office will contact me for payment.Option 2: I would like to pick up the documents myself or have someone else pick them up on my behalf. I understand that these documents will not be mailed to the County Clerks Office (Step 3).
If you selected Option 2, please enter the name of individual picking up the documents. Individual will need to bring a valid ID.
Steps 3 and 4 will be completed by the graduate or authorized individual.

Step 3: Complete the Apostille or Authentication Request Form (ss-4504).

Download the Apostille or Authentication Form

Step 4: Submit the request form, the public document, the county of certification and payment of the processing fee to the address listed below:

Office of Authentications Tennessee Secretary of State
Business Services Division
ATTN: ATS Section
312 Rosa L. Parks Ave – 6th Floor
Nashville, TN 37243

Customers may obtain Apostille or Authentication services in person during regular business hours which are Monday – Friday 8:00 a.m. until 4:15 p.m. Central Time, with the exception of state holidays at our customer service desk at 312 Rosa L. Parks Ave – 3rd Floor, Nashville, TN 37243. You must arrive at our office by 2:00 p.m. in order to receive same-day service.
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: