Request for Replacement Diploma

Replacements: Diplomas which have been lost, damaged, destroyed, or never received may be approved for replacement. Requests for extra diplomas are not approved. Replacement diplomas will bear the signatures of the current officials of Tidewater Community College and the Virginia Community College System. Approved replacement diplomas are sent free of charge.

Name: The name that appeared on the original diploma will also be used on the replacement diploma.

Student Name(Required)

First

Last

Diploma Name

First

Last

(if different from name above)

TCC ID #(Required)

SSN

Please provide the last four digits of your SSN.

Email(Required)

Phone(Required)

Date of Birth(Required)

Mailing Address(Required)

Street Address

Address Line 2

City

State

ZIP Code

Degree(s) Received(Required)

Degree Name

Date Awarded

Reason for Request(Required)

Signature