Diploma/Certificate Request

Diploma/Certificate Request

for CTE Programs
Haney does not issue GED or Haney High School Diplomas/Certificates

Please order these from the appropriate institution listed on our website
Full Name:

First NameMiddle InitialLast Name (WHILE ATTENDING HANEY)
Social Security Number:
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Email:
Provide the MOST FREQUENTLY checked email.
Phone Number:
Format: (000) 000-0000.
Certificate Earned:
Program(s) Attended:
Diplomas/Certificates are available for pickup in the Student Services Office for a two (2) week period after reprinting is complete, before being mailed to the address below.
Mail Diploma/Certificate to:
Name of Person, Business, or Institution:
Address:

Street Address

Apt, Suite, etc. (Optional)

CityState

Postal / Zip Code
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Haney does not issue GED or Haney High School Diplomas/Certificates