Please read carefully then follow instructions on form for Novelty Transcript:
To order a transcript PRINT THIS PAGE on Your Printer First, fill in the Questions, Sign, and mail complete
form with CASH or MONEY ORDER IN US DOLLARS, MONEY ORDER MUST BE PAYABLE ON A US BANK to D. Moore at P.O.Box
183 - Hillview Kentucky 40129-0183 . Allow 5-10 working days for return. Don't forget to add cost of mailing if
You want any special return mailing. If not completely satisfied, e-mail immediately upon receipt of order that
you were not satisfied and are requesting a refund, You then have 2 days to return it in the same condition as
received for a full refund less postage cost. Your return Post Mark will verify when you place it in the return
mail, this is to prevent customers using the documents for their needs and then requesting a refund.
Important: PLEASE print or type where I may read it, there will be a charge for any certificate reworked due
to errors caused by not being able to read the order form!
View Sample Transcript HERE
"ORDER"FORM" TO BE COMPLETED
FOR COLLEGE TRANSCRIPT:
Note: Please fill in the following information exactly as wanted printed on certificate!
1. NAME OF COLLEGE OR HIGH SCHOOL __________________________________________________________________
2. LOCATION OF COLLEGE OR HIGH SCHOOL ______________________________________________________________
3. CITY STATE/COUNTRY AND ADDRESS OF INSTITUTION IF AVAILABLE ___________________________________
_________________________________________________________________________________________________________
4. DATES ATTENDED INSTITUTION _______________________ DATE OF GRADUATION ___________________________
5. STUDENTS NAME WHILE ATTENDING INSTITUTION _______________________________________________________
6. STUDENTS ADDRESS, CITY, STATE, ZIP CODE WHILE ATTENDING INSTITUTION ______________________________
____________________________________________________________________________________________________________
7. STUDENTS CITY, COUNTRY, ZIP CODE IF OTHER THAN IN USA ______________________________________________
____________________________________________________________________________________________________________
8. SOCIAL SECURITY NO., OR OTHER I.D.(STATE TYPE IF NOT SS #) ____________________________________________
9. DATE OF BIRTH (MM/DD/YYYY) ____________________________________________________________
10. MAJOR FIELD OF STUDY ____________________________________________________
11. STUDENT I.D. NO. __________________________________________________________
12. CHECK THIS BOX IF YOU WANT A COMPUTER GENERATED SIGNATURE FOR REGISTRAR _________
13. CHECK THIS BOX IF YOU DO NOT WANT ANY SIGNATURE APPLIED TO TRANSCRIPT _________
14. CHECK THIS BOX IF YOU WANT EMBOSSED SEAL WITH WORDING (UNIVERSITY REGISTRAR OFFICIAL SEAL
) APPLIED OVER REGISTRAR'S COMPUTER GENERATED SIGNATURE ______:
14-A. FORMAT OF TRANSCRIPT WANTED R______ V ______ H _____ PLEASE CHECK ONE, IF NONE IS
CHECKED THE DEFAULT IS R:
TO BE ADDED WITH THE ABOVE FOR HIGH SCHOOL TRANSCRIPTS:
15. SEX ___________ RACE ____________ HOME TELEPHONE AT TIME YOU ATTENDED THIS SCHOOL (MAKE ONE
UP IF
YOU LIKE)_____________________
16. TOTAL CREDITS _________ 12. PARENT/GUARDIANS NAME ____________________________________________
17. DATE OF GRADUATION (MM/DD/YYYY) ____________________________________________________________
18. SPECIAL CLASSES, SPORTS, HONORS OR OTHER MATTER YOU MIGHT WANT TO ADD TO THE DOCUMENT:
________________________________________________________________________________________________________
** IMPORTANT **
IF YOU WANT SPECIFIC INFORMATION APPLIED TO YOUR TRANSCRIPT, COURSES, GRADES, DATES,
YOU MUST FILL OUT THIS FORM!
To obtain Form for Academic Transcript Information select here
must have this information if you are requesting any specific information to your transcript as courses,
grades, attendance date, etc.
IF YOU NEED MORE LINES PLEASE ATTACH ANOTHER PAPER TO ORDER FORM WHEN MAILING
NOTING SPECIAL INSTRUCTIONS:
DECLARATION (to be read by ALL prospective clients and customers). If you intend to order a
certificate, you are reminded to read and sign the following notice prior to posting any orders. In consideration
of my order I hereby release and forever discharge Home School Diplomas, it's agents, instrumentalities, and representatives
of all liabilities, claims, damages or costs which I may have against them arising out of, or in any way connected
with my order and receipt of such certificate and/or any other product from Home School Diplomas. I understand
this waiver includes claims based on negligence, action, or inaction of myself and of any other parties. By affixing
my signature I hereby agree to release all persons affiliated with Home School Diplomas from all damages that may
arise from fraudulent, misrepresentative, and illegal use of certificates and/or any product provided by Home School
Diplomas. While every care is taken to ensure the accuracy and integrity of the information pertaining to products
provided by Home Schools Diplomas, the parties involved in the design of this website take absolutely no responsibility
whatsoever for any damages or liabilities arising out of the unlawful misuse of such products. Please note that
orders NOT accompanied by the following completed form with the appropriate signatures and payment, including
miscellaneous incidental mailing and handling costs in the form of U.S. Money Order or Cash will either be returned
or result to delay of processing. I the undersigned understand and confirm that this certificate was made for me
to my specification as a novelty item. I will not misrepresent it as an official document from said university,
college, or school in any fraudulent manner. With my signature I confirm and accept full responsibility for the
contents of and for any use or misuse of this certificate or degree after receiving it. By signing below I agree
with all the aforementioned conditions.
Signature__________________________________DATE____/_____/ 20______
WE RESERVE THE RIGHT TO REFUSE SERVICE TO ANYONE
"MAILING INFORMATION"
Within the USA Mail to: Name __________________________________________________________
Address: Street and Number ____________________________________________________________
City: __________________________________,State: _________________Zip: __________________
E-Mail Address: (THIS E-MAIL ADDRESS WILL ONLY BE USED TO CONTACT YOU IF WE HAVE QUESTIONS REGARDING
THIS ORDER, OTHER WISE WE WILL BE REQUIRED TO RETURN THE ORDER INCOMPLETE IF PROBLEMS ARISE)
E-mail_____________________________@_______________________________________
Outside the USA Mail to: Name__________________________________________________
1st Address_________________________ 2nd Address________________________________
City/Town____________________ Zip/Country Code__________Country__________________
Telephone ( _____ ) ____________________________
Fax ( _____ )_________________________
NOTE: Check appropriate box for mailing. Please state by placing a check mark if you wish to WAIVER
SIGNATURE when receiving EXPRESS MAIL! _______ Yes I wish to WAIVER SIGNATURE on my return mail, **NOTE**
you will have to sign for document if this box is not checked! PLEASE
WAIVER SIGNATURE WHEN SENDING EXPRESS MAIL TO ME, IF NOT IT COULD DELAY YOUR ORDER AS MUCH AS THREE DAYS!