Diploma Reorder Form
Student Name: _____________________________________ ID# or SSN: _________________
Diplomas normally take 3-5 weeks to be delivered and the cost is $25.
Enclosed is my check for $25 payable to Concordia University.
Please charge my credit card $25.
Please add $25 to my order for my diploma to be mailed by Express Mail.
Credit Card # _______________________________ Exp. Date ____________ CVV Code ______
Please mail my diploma to the following address:
_______________________________________
_______________________________________
_______________________________________
Bachelor of Arts/Science
Master of Arts/Education/Business Administration
Please print your name exactly as you want it to appear on your diploma.
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Student Signature: _________________________________ Date: _______________________
MAIL to:
Concordia University
Registrar’s Office
1530 Concordia West
Irvine, CA 92612
FAX to:
SCAN to:
949-214-3505
registrar@cui.edu
If you have any questions, please contact the Registrar’s Office at 949-214-3079.
----------------------------------------------------------Office Use------------------------------------------------------Payment:_________________
Ordered:______________
Sent:________________