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.
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
Email Address (used to create your diploma account)

Confirmation Email
Phone Number

Area CodePhone Number
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)
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):
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. *The Robertson County Clerk can be reached at 615.384.5895 for payment over the phone.
  - If picked-up completed by: student or authorized individual.
- Step 4: Complete the Apostille or Authentication Request Form (ss-4504). Download the Apostille or Authentication Form
  - 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.
  - If you would like this step completed by Belmont University, there is an additional processing fee. See payment options below.
  - Completed by: student or authorized individual
    
    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.
Do you need your diploma notarized for an Apostille or Diploma Authentication? (Hard Copy of Diploma Required Above:
Do you need your official transcript notarized and included with the Diploma?
I understand that Belmont University can only provide the acceptable documents including the diploma and/ or transcript and notarize these documents.
Document Delivery:
Please enter the name of individual picking up the documents. The individual will need to bring a valid ID.
Please upload the Apostille or Authentication Request Form (ss-4504).

Browse Files

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Choose one of the following diploma options
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
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: