FLINT HILLS TECHNICAL COLLEGE
Request for Replacement Diploma
The cost for a replacement diploma is $10. Payment must be submitted with this form prior to the issuing of the replacement diploma.
Name as you wish it to appear on your diploma
Date of Birth (Required for verification purposes)
Degree Received (Technical Certificate or Associate's Degree)
Please Confirm Email Address
Signature Statement I understand the replacement diploma I am requesting is not an exact duplicate of my original diploma. The signatures on my replacement diploma will be those of current administrators, not those who were in the position to sign upon the issuing of my original diploma.
I verify the information on this form is true and accurate and I am giving Flint Hills Technical College permission to issue a replacement diploma.