Duplicate Diploma Request Form - Christ the King Regional High School

Duplicate Diploma Request Form

CHRIST THE KING REGIONAL HIGH SCHOOL

DUPLICATE DIPLOMA REQUEST FORM

Instructions for Online Requests

- Duplicate Diplomas may be requested online.

- Duplicate Diplomas will only be mailed to the requesting alumni.

- The fee is $35.00 per duplicate diploma request payable by credit card only.

First Name *
Middle Initial/Name
Last Name *
Maiden Name
Address *
Apt Number
City *
State *
Zip *
Home Phone *
Cell Phone *
Email Address *
Date of Birth (MM/DD/YYYY) *
Year of Graduation (YYYY) *
Credit Card *	AMEX Visa Master Card Discover
Credit Card Number *
Expiration Date *
Name on Credit Card *
Address of card holder
City,State,Zip of card holder