Please read carefully then follow instructions on form for High School / Home School Diploma, and GED:

To order a certificate PRINT THIS PAGE on Your Printer First, fill in the Questions, Sign, and mail complete form with payment in 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, KY 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 Home School Diploma... HERE
View Sample High School Diploma and G.E.D. Certificate... HERE
View Sample of Two High School Diploma Formats... HERE

"THIS FORM IS FOR HIGH SCHOOL /HOME SCHOOL DIPLOMA AND GED'S " ORDERS ONLY"COMPLETE INFORMATION BELOW"

Note: Please fill in the following information exactly as wanted printed on certificate!

  1. Name of School:__________________________________________________

  2. Type of School please check one: High School ______ GED _______ or Home School ________

  3. Location Diploma was obtained: Location (City/County): ______________________________________

    (State/Zip) ____________________________

  4. Complete name of person receiving the diploma ______________________________________________

  5. Date Diploma was given (example) May 30, 1990 ____________________________

    or mm/dd/yyyy ___________________________

  6. List titles of signatures wanted at bottom of certificate (examples)Chancellor, Provost, President, Dean of Students or other PLEASE ADVISE BELOW

    (1st)Title ___________________________ (2nd)Title __________________________________

    for additional signature/title, please state _______________________________________________. (NOTE PLEASE) I need to know the TITLE of the person signing the certificate, not the name of the person signing! If wanting specific names to these titles in the form of a computer generated signature please indicate the name of the person below!

    (1st) Title persons name _________________________________________________

    (2nd) Title persons name _________________________________________________

    (3rd) Title persons name if required ________________________________________

    (4th) Title persons name if required ________________________________________

    SIGNATURE LASER PRINTED OR COMPUTER GENERATED (CHECK ONE) COMPUTER GENERATED CHECK HERE _____ OR IF YOU WISH TO SIGN IT YOURSELF CHECK HERE ______ !

  7. Seal type and placement: please advise if You want a (RAISED EMBOSSED SEAL at $6.00 additional cost with your schools name and a logo WHEN AVAILABLE) in GOLD, BLACK. Indicate your choice for RAISED SEAL by checking here and color desired ______ .Location for placement of seal. MIDDLE, RIGHT or LEFT side at bottom of certificate, or other. Your choice for location of Seal _______________. If other than " M " R " L " indicate where on certificate ___________________________.
  8. If you do not want the special RAISED SEAL above at $6.00 additional cost with your schools name and logo when available, you may select from one of these foil seals at NO ADDITIONAL COST ,view Seals by selecting... HERE ... SEAL # _______ List Location for placement of seal MIDDLE, RIGHT or LEFT ______ side at bottom of certificate, If wanting a Printed Seal at no additional charge and check here _____ .Your choice for location of Seal ____ If other than " M " R " L "
  9. Certificate Format: All $60.00 certificates are 8.5 x 11 Printed Horizontal (WIDE) unless other wise specified by checking this BOX ____ and indicating size and format below, please state size if other than 8.5 x 11 here _____ Vert. (LONG) x ______ Horz. (WIDE:), smaller sizes available (SAMPLE) 6 x 8 for the same $60.00 charge, you may also want a laminated wallet size for $30.00 additional cost with any certificate order and check here ____.
  10. Also now available for all 8.5" x 11" certificates a Padded Vinyl Folder in Blue or Green color at $30.00, or a Keepsake Folder in sturdy heavy weight Blue paper with satin corners only $12.00 additional cost, please check here and indicate preference also at bottom of form.________. As of 7-10-2002 I will have the Padded Vinyl Folders in Blue or Green for 6" x 8" certificates at $30.00 .View Sample Here for 8.5" x 11" Folders

    ** PLEASE VIEW SAMPLES OF FORMATS BELOW BEFORE SELECTING **

    HERE Vertical Format

    HERE Horizontal Format

  11. For special instructions attach separate paper. For best results send an EXAMPLE of Certificate.
  12. Blank Transcripts except for Name, Logos and embossed REGISTRAR SEAL for University or other non-existing school may be ordered at $60.00 per page (BLANK), with COURSE DESCRIPTION and GRADES $102.00 first page and $48.00 per additional page with the order of any Certificate or $180.00 first page and $102.00 per additional page without Certificate Order.

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 homeschs 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 School 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 CASH or MONEY ORDER in USD 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 school, church, state or local agency 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 diploma 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 ( _____ )_________________________

** For Novelty purposes only: **

EXPRESS MAILING INSTRUCTIONS PLEASE READ IMPORTANT

    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!

  • Please add $20.00 for US Postal Express Mailing of 8.5 x 11 order within the USA. _____
  • Please add $6.00 for US Postal Priority Mailing within the USA. _____
  • Please add $5.00 for Plain Heavy Weight Kraft Envelope Mailing within the USA. _____
  • Please add $40.00 for Regular US Postal Service International Mail and handling. ______
  • Add $52.00 - $100.00 depending on country destination for US Postal Service International Express Mail and handling. ______
  • * NOTE * FedEx states that it no longer accepts P.O. Box address from sender or receiver THEREFORE FedEx IS NO LONGER AN OPTION!
  • * NOTE * DHL states that it no longer accepts P.O. Box address from sender or receiver THEREFORE DHL IS NO LONGER AN OPTION!
  • * NOTE * UPS states that it no longer accepts P.O. Box address from sender or receiver THEREFORE UPS IS NO LONGER AN OPTION!
  • Provide phone number where you may be reached for delivery. Please include COUNTRY CODE, AREA CODE, and TELEPHONE NUMBER to assure prompt delivery. ______________________________. I assure you that this telephone information will only be used for this reason.

PRICES FOR CERTIFICATES:
$60.00 FOR 8.5 X 11 CERTIFICATE OR SMALLER

PLEASE LIST PAYMENT AMOUNTS ENCLOSED WITH ORDER BELOW:
$ ________ COST OF CERTIFICATES _________ NUMBER OF CERTIFICATES THIS ORDER:
$ ________ LAMINATED WALLET SIZE $30.00 EACH WITH ORDER OF CERTIFICATE
$ ________ PADDED VINYL FOLDER $30.00 EACH, FOR 8.5" X 11" CERTIFICATE ___ OR 6" x 8" CERTIFICATE ____:
$ ________ KEEPSAKE FOLDER $12.00 EACH, FOR 8.5 X 11 CERTIFICATE ONLY:
$ ________ $6.00 EACH FOR RAISED EMBOSSED SEAL:
$ ________ OTHER PAYMENT, PLEASE STATE ________________________________________:
$ ________ SUB TOTAL AMOUNT ENCLOSE WITH ORDER:
$ ________ SUB TOTAL AMOUNT MINUS 20% DISCOUNT FOR CASH PAYMENT** DO NOT INCLUDE POSTAGE IN THIS DISCOUNT OR IF PAYMENT IS MADE WITH MONEY ORDER **ONLY CASH CURRENCY ONLY IN US DOLLARS **!

$________ NOW ADD POSTAGE COST TO THE SUB TOTAL ABOVE:
$________ FULL AMOUNT ENCLOSED WITH THIS ORDER:
$________ CHECK HERE IF USING COUPON AND STATE AMOUNT OF COUPON

YOU MAY NOW PAY USING PAYPAL:

YOU WILL STILL NEED TO COMPLETE ORDER FORM AND SEND BY E-MAIL, LAND MAIL, OR FAX TO 1-502-955-6790
PLEASE PAY AMOUNT LISTED AS FULL AMOUNT ENCLOSED WITH ORDER AS LISTED ABOVE:

**** NOTE ORDERS WILL ONLY BE SHIPPED TO CONFIRMED PAYPAL ADDRESS WHEN PAYING WITH PAYPAL!! ***

LAST UP DATED: 01-27-2012

*** END OF APPLICATION FORM:***