Duplicate Certificate of Completion Request

A duplicate certificate can only be issued if you have completed the course within the last five years.
*Legal Name (When course was completed.)
*Social Security #
*E-Mail
*Telephone Number
*Select course for which you are requesting a duplicate certificate?		Unit I Unit II Both
*What are the course dates? Make sure to include Month & Year. We must have dates to process request.
There is a $35 fee for duplicate Certificates of Completion. Please fill out payment information below.
Card Brand
*Card Number
*Expiration Month
*Expiration Year
Your duplicate certificate will be e-mailed to you at the e-mail address provided on this form.
*We will process your request and send your Certificate of Completion within seven (7) business days. We will not process your credit card until we issue your duplicate certificate. If we have any questions we will contact you by e-mail. We need your exact course dates for class(es) in order to process your request.
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