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Diploma Re-Order Form 

You may order a new diploma if your old diploma has been damaged, lost or stolen 

Student Information – Please print clearly 

EMPLID: D.O.B. / / 

Last 4 Digits of SSN (in attendance prior to SPRING 2012 semester) 

(Due to archiving, please provide your full SSN ONLY if you have graduated prior to 1991) 

Last Name First Name Middle Initial 

 

Street Address: City, State, Zip: 

 

Phone (_____) _____ ---- _________ Email: 



 

Please provide the following to complete your request - 



. Identification card (State-issued identification card) 
. $30 check or money order signed and made out to Lehman College must accompany all request. 
. In-person orders must be paid at the Bursars office located in Shuster 031 during office hours 


 

 

Conferral Date: 

 

Academic Program (Degree): 

 

Academic Plan (Major): 

 

College Honors (if applicable): 

 

 

Student Signature Date 

 

PROXY PICK-UP 

If you prefer to have your diploma picked up by a friend or relative (PROXY), please follow the instructions 
found at the following link http://lehman.edu/registrar/graduation-information.php to download & complete 
your PROXY request. 

If you have any additional questions or concerns regarding the information above please refer all inquiries to 
Graduation.Audit@Lehman.cuny.edu (or) call the Graduation Audit Office (718) 960-7474. 

 

 

Office Use Only: 

Thank you, Received by: _________ Date: _____ 

Office of the Registrar Processed by: ________ Date: _____