Duplicate Diploma Request Form

Student Name:Missing or incorrect value	Student ID #:
Phone Number:Required for international delivery

Note:

Mail Check to:

Lynn University
Registrar’s Office
3601 North Military Trail
Boca Raton, FL 33431-5598

Or

Payment can be made at www.lynn.edu/emarket. Select Duplicate Diploma option. (The diploma will not be processed until payment is received.).

Date:

Type of Degree:Missing or incorrect value

Your name as it should appear on the diploma. It must match your legal name of record at Lynn University.Missing or incorrect value

Delivery MethodI will pick up DiplomaMail Diploma to:Missing or incorrect value

Identifying Document: Each request must be accompanied by a copy of one of the following photo IDs.Driver's LicenseLynn University IDPassportMissing or incorrect value	Please attached identification Missing or incorrect value
Signature: Clear Missing or incorrect value	Date: