WBU
Application for Graduation
Associates in Applied Science (AAS)
Bachelor of Science in Occupational Education (BSOE)
lighting the way
I request a replacement Diploma for D AAS D BSOE orD BCM degree (check one) from Wayland Baptist University.
The last campus I attended with Wayland was----------------------! am providing the following information to process my application: (Please print clearly)
REPLACEMENT DIPLOMA
Please return this application and the appropriate fee to the Plainview campus-Attn External Programs.
I want my name PRINTED ON MY DIPLOMA as
Date of Graduation
Social Security Number
Current Mailing Address
Street, Number, or PO Box
City
Current Phone Numbers
Zip Code
State
(Wo,k)
(Home)
E-mail Address
Permanent Address
Street, Number, or PO Box
City
Zip Code
State
The fee for requesting a REPLACEMENT DIPLOMA is $50.00 per diploma requested.
The "Replacement Diploma" request form with payment is sent to Wayland Baptist University, 1900 West
7'\ Attn: External Programs #1267, Plainview, TX 79072
My signature below signifies that I understand that this request will take from four (4) to six (6) weeks to process. I further
acknowledge that I reviewed the information I listed above for correctness, and I assume full responsibility for any errors that
I have made on this REPLACEMENT DIPLOMA request form.
Signature of Student
Date
FOR OFFICIAL USE ONLY
Bnsiness Office.________________
Graduation Fee Paid ( $ 50.00 per diploma)
(date), _____
All Obligations arranged (date),_________ Bnsiness Office.________________
Diploma Granted (date)____________ Registrar -------�M ajor _______
- --
Revised 5-10-2005
-
-
-