Complete this form if you are changing your mailing address after you have applied for graduation or to have a diploma that was never picked-up mailed to you.
Instructions:
- Complete all information requested below and submit via fax (330-941-1408), e-mail (records@ysu.edu), or in person at the Penguin Service Center, Meshel Hall, 2nd floor.
- Provide a valid photo ID (driver's license, passport, YSU ID, etc.).
- Complete all information requested below.
Student/Graduation Information:
Name:_______________________________________________________________________________________________
First MI Last
Student ID# or SSN:________________________________
Name at time of graduation:_______________________________________________________________________________
(if different from above)
Date of Birth:________________________________
MM/DD/YYYY
Degree Earned: (BA, BSAS, etc.):_________________________________________________________
Graduation Term & Year: (Fall 2019, etc.):___________________________________________________
Phone Number (required):____________________________________________
Email (required):____________________________________________________
Do you need a diploma cover? (current graduates will receive a diploma cover at the commencement ceremony)
___Yes, please send a cover. ___No, I do not need a cover.
Please check one of the following:
___I am graduating this semester, have already applied for graduation, and need to change my diploma mailing address.
___I am an alum and never picked-up my diploma.
___Other:____________________________________________________________
New Diploma Mailing Address:
Address:_________________________________________________________________________________________________________________
Address 2:_______________________________________________________________________________________________________________
City:_________________________________________ State:______________________ Zip:____________________________
Country (if other than USA):_________________________________________________________________________________
Would you like us to update your address in the YSU system? ___No ___Yes
(if yes, your photo ID must contain the new diploma mailing address listed above to update YSU's information system)
Student Signature:____________________________________________________________________ Date:_____________________________
For Records Use Only
ID checked:_________ Updated in Banner:________ Diploma ordered:________ Diploma mailed:_________