Request for Certificate

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Please complete the following form to request a certificate from the Division of Workforce Development and Continuing Education at Kingsborough Community College.

Replacement certificates can be issued for a $10.00 fee (per certificate).

Please note: You must provide all required information below. We are regrettably unable to process certificate requests that are missing any of this information.

As per state law, we are only required to maintain program information for a maximum of seven years for certificate courses.

A response will be provided within 5-10 business days.

Email *

Full Name (at the time of enrollment)

Date of Birth *

YYYY

Program/Course Name *

Semester completed course/program *

Instructor Name (If available)

How do you want to receive the certificate? *

Electronic- sent to the email address on this form

Mailed to my home. (Provide address in the next section)

If you chose "mailed to my home," please provide us your mailing address here:

Any other information you wish to provide?

Send me a copy of my responses.

Submit

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