Park University Duplicate or Replacement Diploma Order I f you would like to order additional Park University diplomas (post graduation) please place your order through the Office of Alumni Relations. These diplomas will bear the signature of the current University President and current chairman of the board of trustees. To order the new diploma, please complete the form below and submit $75.00 to: Office of Alumni Relations Park University 8700 NW River Park Drive Parkville, MO 64152 Name Printed on Original Diploma: __________________________________________________Year of Graduation: _________ Please send a photocopy of the original diploma if possible. If requesting a diploma in a different name, please provide proof of legal name change. Current Name: _____________________________________________________________________________ Mailing Address: ___________________________________________________________________________ ___________________________________________________________________________ Email : _______________________________________ Phone: _________________________________ Payment Method: Check or Credit Card: Visa Mastercard Am Exp Discover Card #: _____________________________________________ Expiration Date: ______________________ Name on credit card: _______________________________________________________________________ Signature: ________________________________________________________________ Date: __________ Diplomas may take up to 90 days to produce. Proceeds support the Marlowe Sherwood Memorial Scholarship Fund— the Park University Alumni Association’s Legacy Scholarship the scholarship created by alumni for alumni Name to be Printed on Diploma: ______________________________________________________ Park ID #: CID #: