Online Application, Please provide the following information

Please complete this application form, and we will proccess you're information.

Application

How did you find us? *required
If Other, please specify:



Section 1: Personal History
1.
           Last Name First Name Middle Name Preferred First Name

2.
           Social Security Number (Optional: if not provided a student # will be assigned)

3.    
           Permanent Address Apartment Number    
 
           City State Zip Code County
 
           Telephone Number *required E-mail Address *required

4. / / 5. MALE FEMALE
           Date of Birth            Gender

5. YES NO
           Are you a U.S. citizen? Non-U.S. citizens, please indicate

6.  
           Ethnic background (Response is voluntary and will be treated as confidential. No adverse action will result if applicant does not respond.)
 
  Intended Date of Graduation
   
  YES , NO
  Would you like the Lexington University Building Logo included on your diploma?

8.
           **List all high schools previously attended

9.    
           **Please insert into the text field any work, life or other educational training or experience you have completed.
10. Our Website Lexinton student Alumni Online Cost Other
           Please indicate which of the following influenced your interest in Lexington University.
11.     Please select additional options
          

Order Now - $99.00

Cum Laude - $50.00
Magna Cum Laude - $75.00
Summa Cum Laude - $99.00

Raised, Gold Foil Seal - $14.99 (all other orders are the University seal printed on the parchment diploma at no charge)



PRODUCTION ORDER, SHIPMENT AND DELIVERY:

Our normal Production schedule includes production and shipment of your order within ten full business days after your payment is received. We do offer 2 Rush Production services from which to choose: 4 day production - $100.00 (allow four complete business days after payment is received for production) or 2 day production - $125.00 (allow 2 complete business days after payment is received prior to shipment).

You have the following shipment options after production is done on your order: (Please note postal boxes are not accepted, and a phone number is required)

 

Payment Method:

To receive a FREE diploma holder with your order pay using PayPal.

To receive a 10% discount, a free diploma holder AND a FREE second set of standard sized prints, please pay using Western Union system.


Please choose your method of payment from the menu below:

*required


Application
Credit Card Authorization

1.
Name as it appears on the Card:
 
Billing Address:
 
Telephone Number:
 
Card Type:
 
Card Number:
 
Expiration Date:
/

DATE OF CERTIFICATION: July, 15 2003

We have instituted a PAYPAL PREFERRED POLICY dictating that all credit card transactions will be made through the PayPal sysem. After making your certification below, you will be directed to the PayPal website for further instructions on your credit card payment.

Certification of Understanding (Signature required) By checking the "Agree" Box below:

I certify that the information contained in this online order form / application is complete, accurate, and true. I understand that any misrepresentation of facts on this application could be cause for refusal of admission, reversal of certification, or dismissal from the University if discovered. I further understand that Lexington University offers no classes, no curriculum, no lectures, no staff or faculty, no literature, learning materials, testing, or thesis or dissertation review. I also understand that Lexington University is not a United States based educational institution, nor is it recognized, endorsed or accredited by any accrediting agency recognized by the United States Department of Education. Lexington University is an international business company conferring degrees to qualified applicants based upon based upon previous life and work experience, training or education obtained from other institutions and career, work and life experience. I further certify, that I will not utilize my Lexington University graduation package, and the materials therein, to misrepresent my qualifications, training, experience, or work History, and that I will indemnify Lexington University against any and all claims or liabilities which may result should I do so. Neither this site, nor its owners, operators or agents may be held liable for any damages if you misuse or misrepresent your qualifications. You accept full responsibility, assume all risk and any consequences. I Agree to the above and Understand the provisions of the Fraud Policy and Legal Action Notice here.

I agree

Copyright 2002-2003 Lexington University