Reorder Diploma Form | Registration

Upon submission of this form, you will be sent a confirmation email and charged a $10 replacement diploma fee. The fee may be paid online through your MyUT account or with cash at the Cashier’s Office. Please email graduation@utahtech.edu if you have any questions.

Reorder Diploma Form

Personal Information

First Name: *

Middle Name: *

Last Name: *

Maiden or Former Name:

Digital ID

Birth Date: *

Email Address:

Diploma Information

Choose University

Utah Tech

Dixie State

Name as you would like it to appear on your diploma: *

Degree Earned: *

If your name differs from our records, you must complete an Information Change form. Info Change

Delivery Information

Hold diploma at the Registration and Records Office or mail diploma: *

Please hold diploma at Registration and Records Office

Mail diploma to the following address

Please enter address here if applicable