Duplicate Diploma Request

This form is to be used by former students to request a duplicate diploma.

The cost for each Diploma order is $20.

Payments in the form of a check or money order payable to SUNY Old Westbury should be mailed to:

Office of the Registrar
Attn: William Polaski
SUNY Old Westbury
P.O. Box 210
Old Westbury, New York 11568

Your diploma request will not be process until payment is received.

Please allow a minimum of 6-8 weeks for processing.

Student Information

First

Last

Name on Diploma

If the name above is different from the name on your student record, you will need to attach your social security card and a state issue photo ID

Number of Diplomas ($20 per Diploma)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Additional Identifying Information

DOB (MM-DD)

Approximate dates of attendance

Date of Graduation

Major

State Issued ID

One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx.

Additional Document

If the name on your diploma is different from the name used to attend SUNY Old Westbury, please upload a copy of your Social Security Card.
One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx.

I understand that entering my full name in the space below serves as my signature