Student ID Replacement

Student ID Replacement

The replacement fee for lost, damaged, and stolen cards is $25. You may pay your replacement fee online with a credit card or debit card using this secure form.
Full Name*

First NameMiddle NameLast Name
Professional Photo Upload*

Upload a professional photo that will be used for your student ID.
Cancelof
UHSA Student ID Number*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Where would you like your ID card sent?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Diploma Replacement or Copy*

ID Replacement

First-Class Mail

$25.00

ID Replacement

FedEx 2 Day Shipping

$35.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Signature*
Any payments made in accordance with this form submission shall, once they are paid, not be refundable nor creditable for any reason whatsoever.
Should be Empty: