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Please read carefully then follow instructions on form for Novelty Certificate, Diploma, or Degree:

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, 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 and $18.00 for special handling if ordering 10 x 13 or 11 x 14 certificate. 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!

H.S. DIPLOMA WILL REJECT ALL ORDERS THAT REQUIRE THE USE OF NAMES OR INSTITUTIONAL SYMBOLS OF ANY EXISTENT ACCREDITED UNIVERSITY (NO EXCEPTIONS!). CLIENTS ARE REMINDED THAT EXISTENT UNIVERSITIES AND COLLEGES HAVE THE LEGAL RIGHT TO RETAIN ALL RIGHTS AND CLAIM OF OWNERSHIP PERTAINING TO THE USE OF COPYRIGHT- PROTECTED INSTITUTIONAL NAMES AND SYMBOLS. THEREFORE CUSTOMERS ARE ENCOURAGED TO ORDER PRODUCTS WHICH IN NO WAY TRANSGRESS THIS RIGHT. A CERTIFICATES BEARING ANY NON-EXISTENT INSTITUTIONAL NAME WILL BE ACCEPTED AND PROCESSED WITHOUT DELAY. IN NO WAY DOES H.S. DIPLOMA OR MYSELF CLAIM TO BE CONNECTED IN ANY FORM TO ANY UNIVERSITY, SCHOOL, OR AFFILIATIONS! ....ALSO ABSOLUTELY NO ORDERS PROCESSED WITHOUT MAILED WRITTEN APPLICATION FORM AS OF 4-26-99, E-MAIL APPLICATIONS WILL NO LONGER BE ACCEPTED!

"THIS FORM IS FOR DEGREE CERTIFICATE " ORDERS ONLY "COMPLETE INFORMATION BELOW"

Please view this list of Institutions before making a NAME selection, if the NAME is listed on either list I will NOT be able to provide that named Institution on your certificate/transcript order (NO EXCEPTIONS!) Your order will be returned incomplete if you use any of these NAMES as well as any other EXISTING ACCREDITED INSTITUTION! To view list by State as requested by Several Law Firms and The Collegiate Licensing Company as well as the Institutions them self select.....HERE... To view list by A through Z select...HERE...PLEASE VIEW BOTH LIST BEFORE MAKING ANY SELECTION! For a list of COLLEGES that have gone DEFUNCT in the past years and you may use to obtain a name if the Institution that you are wanting is a EXISTING ACCREDITED INSTITUTION HERE...

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

  1. Name of Academic or Professional Institution, (COLLEGE or UNIVERSITY)or a Non-existent and Non-accredited Institution, and most Foreign Schools may be acceptable. _____________________________________________________.
  2. Complete or Full name of person receiving the degree or diploma ____________________________________.
  3. Required Academic/Professional Degree or Diploma:(example) Bachelor of Science, Master of Education or Diploma. PLEASE fill in EXACTLY as wanted PRINTED on Certificate_________________________________________________________.
  4. Departmental, Collegiate or Faculty Designation:(IF THIS APPLIES AT YOUR MAIN INSTITUTION) the college or school desiring degree from (example..) College/School of Business Administration, College/School of Arts and Sciences, College/School of Engineering, ________________________________________________.
  5. Date of Conferral of Degree or Diploma was given (example)May 30, 1990 _________________.
  6. Signatures printed by computer generated or left blank and you fill in yourself. Computer generated _____ I will fill in myself _____ check one.
  7. Location of Institution where you received the degree/diploma(example)Lexington, Kentucky________________________.
  8. Seal type and placement: please advise if You want a (RAISED EMBOSSED SEAL at $5.00 additional cost with your schools name and a logo) 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 ___________________________.
  9. 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 "
  10. 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 ( NOTE) Sizes 10 x 13 or 11 x 14 are available for ($102.00), Plus additional($18.00) for shipping and handling of larger size, 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 ____.
  11. Also now available for all 8.5" x 11"certificates a Padded Vinyl Folder in Blue or Green color at $30.00 additional cost or 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 the 6" x 8" certificates at $30.00 View Sample Here of the 8.5" x 11" Folders.

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

    HERE Vertical Format

    HERE Horizontal Format

  12. For special instructions attach separate paper. For best results send an EXAMPLE of Certificate.
  13. List titles of signatures at bottom of certificate (examples)Chancellor, Provost, President, Dean of Students or other PLEASE ADVISE
    (1st)Title ________________________________ (2nd) Signatures Title __________________________________ for additional signature/title,
  14. 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 laser printed signature please indicate the name of the person below!

  15. (1st) Title persons name _____________________________________________________

  16. (2nd)Title persons name _____________________________________________________

  17. (3rd)Title persons name _____________________________________________________

  18. (4th)Title persons name _____________________________________________________

  19. Signatures are Laser Printed, if you do not have specific names you may choose to have Computer Generated signatures applied. Please select one and indicate by checking the appropriate box, COMPUTER GENERATED ________ PLEASE USE THE NAMES INDICATEDE ABOVE AND LASER PRINT _________ OR PLEASE LEAVE THE SIGNATURES BLANK AND I WILL SIGN MYSELF _________
  20. 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 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 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 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 ( _____ )__________________________________

** For Novelty purposes only: **

PRICES FOR CERTIFICATES:
$60.00 FOR 8.5 X 11 CERTIFICATE OR SMALLER
$102.00 FOR 10 X 13 OR 11 X 14

PLEASE LIST PAYMENT AMOUNTS ENCLOSED WITH ORDER BELOW:
$ ________ COST OF CERTIFICATES _________ NUMBER OF CERTIFICATES THIS ORDER:
$ ________ ADD $30.00 FOR 10 X 13 OR 11 X 14 FOR SPECIAL HANDLING:
$ ________ LAMINATED WALLET SIZE $30.00 EACH WITH ORDER OF CERTIFICATE:
$ ________ PADDED VINYL FOLDER $30.00 EACH, FOR 8.5" X 11" CERTIFICATE ____ OR 6"X8" 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 ** CASH CURRENCY ONLY **!:

$________ 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

NOTE: MULTIPLE ORDERS WILL BE MAIL TOGETHER IN ONE ENVELOPE UNLESS OTHERWISE SPECIFIED WHEN ORDERING.


YOU MAY NOW PAY USING PAYPAL AND YOUR CREDIT CARD:

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: 01-26-2012

*** END OF APPLICATION FORM:***