Diploma Mailing Form

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:

  1. 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.
  2. Provide a valid photo ID (driver's license, passport, YSU ID, etc.).
  3. 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:_________

 

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