Office of the Undergraduate Registrar * Proctor Hall * Room 207
620 George Street * College Ave Campus *  New Brunswick * New Jersey  08901

 DIPLOMA REQUEST FORM

_____    I will pick-up my diploma at the Registrar's Office - Call (848)445-2757 to verify
              availability

_____    I will not attend the May Commencement Ceremony

_____    I will attend the May Commencement Ceremony.  Diplomas for Schools 01, 02, 06,
               12 and 61 will not be distributed at Commencement.

_____    Please mail my diploma via the U.S. Postal Service. The University is not responsible
              for any loss or damage that may occur in transit. Mail my diploma to the Permanent
              Address listed in the database. This address is new as of: ___________
 

Diploma Name:     __________________________________  RUID: ___________________

Address:                 ________________________________________________

                                _______________________________________________

                                ________________________________________________

Home Phone or Cell Number: _______________________________________

If the above address changes prior to, or after Commencement, I will notify your office
of my new address.
 

School: _____________________________________________

Degree Date: ________________________________________
 
 

Signature:_______________________________________ Date:________________
 

Please fax (732-445-4238) or mail this form to the above address
Edited: 5/15/08