Registrar's Office - Request for Certification

Request for Certification
Student Name

First NameLast Name
Student E-mail
example@example.com
Phone Number
Please enter a valid phone numberFormat: (000) 000-0000.
Date of Birth
Student Division
Are you an alumni?
Graduation Year
Name at time of attendance
If different from above
Certification

Other (Please explain)
State(s) for Bar certification
Special Instructions
Delivery Method
Fax Number
Please enter a valid fax numberFormat: (000) 000-0000.
Mail-to Name

First NameLast Name
Mail-to Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Signature
Today's Date

MonthDayYear
Please note: Certifications take 2-3 business days to process. Processing time may be extended up to 7 business days during periods of heavy volume, such as exams and graduation.
Should be Empty: