Order Form for a BACKDATED DIPLOMA from Jostens

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Use this form to order a Backdated Diploma from Jostens if you have lost your original Diploma.

Remember to enter your full name as it was when you graduated from CHS, Make sure to include your middle name and enter your maiden name for your last name.

Jostens currently charges $35.00, payable by credit or debit card directly to Jostens.
Add $15.00 if you need it expedited.

Jostens will contact you shortly after this form is submitted.

Email *

FULL LEGAL NAME when you graduated. *

DATE OF BIRTH *

YYYY

GRADUATION DATE. Month/Year MM/YYYY *

CELL PHONE NUMBER *

EMAIL ADDRESS *

MAILING ADDRESS Street Number, Street Name, Apt #(if needed), City, State Zip Code *

I confirm I am ready to pay $35.00 by credit or debit card to Jostens. *

Yes

I understand there is a 7-10 day turnaround time without expedite fees. *

Yes

Do you need this expedited? If you need it expedited to you, the extra charge is $15.00. *

Yes, and I understand I will need to pay Jostens an extra charge of $15.00 to have the Diploma expedited to me.

No. I do not need the Diploma expedited to me.

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