High School Diploma Application
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High School Diploma Application
Applicant E-Mail
Important: Enter a valid e-mail address. Correspondance will be sent to this address.
*E-Mail:
Applicant Information
*Student First Name:
Middle Initial:
*Last Name:
*Address Line 1:
Address Line 2:
Apt. or Suite No.
*City:
*State:
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*Zip Code:
Home Phone:
Work Phone:
Cell Phone:
*Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
*Social Security Number
*Gender
Male
Female
Ethnic Origin:
Select
Ethnic Origin:
African American
Asian
American Indian
Hispanic
Multiracial
White
Applicants must have all official high school
transcripts sent directly to our school if possible.
Education Information
*High School last attended:
*City/State:
*Last Grade Completed:
Last Grade Completed
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
*Trade School or Other Formal Training?:
Yes
No
If Yes, Type of Training:
*Professional Licenses or Certificates?:
Yes
No
If Yes, what type?:
Is certification or license current?:
Yes
No
Military Service Information
*Military Service?:
Yes
No
If Yes, What Branch:
What was your rank upon discharge:
What was your speciality:
Lifestyle Information
*Are you a parent?:
Yes
No
How many children:
*Do you or have you ever played sports:
Yes
No
If yes, what sport:
*Do you or have you ever coached a sport:
Yes
No
If yes, what sport:
Any trophies or sports awards?:
Yes
No
BBall, bowling, karate, etc.
Alternate Contact Information
*First Name:
Middle Initial:
*Last Name:
*Address Line 1:
*City:
*State:
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
*Phone:
E-Mail:
Payment
*Diploma Package:
Diploma Package:
PACKAGE INCLUDES:
Your High School Diploma
Padded Diploma Holder
Official Transcripts
Lifetime Verification Service
Verification Letters
Award of Academic Excellence
Grand Total:
By clicking the ``Submit Application`` button below, I hereby certify that all the
information I have given is accurate to the best of my knowledge.
I also understand that I am responsible for meeting the minimal criteria required for receiving my diploma.
*Signature:
Enter first & last name
Enter the security code shown above
in UPPER CASE.
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