Arcadia University
Office of the Registrar

Application for Replacement Diploma

Graduates of Beaver College/Arcadia University are eligible to receive a replacement diploma at a cost of $35.00 each (processing fee and postage). If you received more than one degree and are requesting a replacement diploma for each degree, you should fill out a separate form for each degree you would like to replace at a combined fee of $35.00. This form can be copied and is also available on the University’s Web site at www.arcadia.edu under the Registrar’s Office link. Mail the completed form(s) to Arcadia University, Registrar’s Office, 450 S. Easton Road, Glenside, PA 19038, fax to 215-572-2126 or scan/image and email to registrar@arcadia.edu. Requests should be processed in two to three weeks of being received, depending on the volume of requests. Questions should be addressed to the Registrar’s Office at 215-572-2931.

Please print all responses in block capital letters.
My name at graduation was: 	
My name appeared on the diploma as: 	
The degree I earned was: 	
The date I earned the degree was: 	
My address at the time the degree was awarded was:
	
My current address is:
____________________________________________________________________________________ (Your Arcadia University diploma will be sent to this address unless you note otherwise.)
Last 4 digits of my Social Security number: 	
My day phone number is: __________________My evening phone number is: 	
My e-mail address is: 	

Payment Information:           _____Cash                    _____Check (made payable to Arcadia University)
Credit card #: _________________________________________________Exp:___________________
                                            CVV/CVC code:___________________ Billing Zip Code:______________

I certify that all the information I have provided Arcadia University in this application and in any other supporting document is true and correct and that I have not knowingly withheld any information. I understand that any misrepresentation or material omission of fact is cause for rejection of this application.

Applicant's signature:____________________________________________________Date:_________________