Diploma Order Form (Nonmember) "*" indicates required fields Δ Contact InformationIs this your first time registering for an event or activity or your first transaction with NCHE?*Please select yes or no. Yes No Primary Contact Name*Parent, legal guardian or member of the household First Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code North Carolina County in which the homeschool is located*Alamance CountyAlexander CountyAlleghany CountyAnson CountyAshe CountyAvery CountyBeaufort CountyBertie CountyBladen CountyBrunswick CountyBuncombe CountyBurke CountyCabarrus CountyCaldwell CountyCamden CountyCarteret CountyCaswell CountyCatawba CountyChatham CountyCherokee CountyChowan CountyClay CountyCleveland CountyColumbus CountyCraven CountyCumberland CountyCurrituck CountyDare CountyDavidson CountyDavie CountyDuplin CountyDurham CountyEdgecombe CountyForsyth CountyFranklin CountyGaston CountyGates CountyGraham CountyGranville CountyGreene CountyGuilford CountyHalifax CountyHarnett CountyHaywood CountyHenderson CountyHertford CountyHoke CountyHyde CountyIredell CountyJackson CountyJohnston CountyJones CountyLee CountyLenoir CountyLincoln CountyMcDowell CountyMacon CountyMadison CountyMartin CountyMecklenburg CountyMitchell CountyMontgomery CountyMoore CountyNash CountyNew Hanover CountyNorthampton CountyOnslow CountyOrange CountyPamlico CountyPasquotank CountyPender CountyPerquimans CountyPerson CountyPitt CountyPolk CountyRandolph CountyRichmond CountyRobeson CountyRockingham CountyRowan CountyRutherford CountySampson CountyScotland CountyStanly CountyStokes CountySurry CountySwain CountyTransylvania CountyTyrrell CountyUnion CountyVance CountyWake CountyWarren CountyWashington CountyWatauga CountyWayne CountyWilkes CountyWilson CountyYadkin CountyYancey CountyPrimary Contact Email*A confirmation email and a proof will be sent to this email address. Telephone*Student's Email Non-Member Sample Diploma NCHE Weekly Email*Would you like to receive our weekly homeschool news email? It is full of helpful and important information about homeschooling in NC! Yes, please send me the email. No, not at this time. I already receive the NCHE Weekly Email Diploma InformationThe following information is used to produce the diploma. Please enter the required information as it should be formatted for the diploma. Name of Homeschool:*The homeschool issuing the diploma, as filed with the North Carolina Division of Non-Public Education Note: The school name will be printed in Old English Text MT. For best results, don't use all caps.Homeschool City and State:*The city and state in which the school is located City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Graduating Student's Name:*If the student has more than one middle name, add them to the middle name field. First Name Middle Name Last Name Suffix Graduation Month*JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberGraduation Day*firstsecondthirdfourthfifthsixthseventheighthninthtentheleventhtwelfththirteenthfourteenthfifteenthsixteenthseventeentheighteenthnineteenthtwentiethtwenty-firsttwenty-secondtwenty-thirdtwenty-fourthtwenty-fifthtwenty-sixthtwenty-seventhtwenty-eighthtwenty-ninththirtieththirty-firstGraduation Year*two thousandtwo thousand onetwo thousand twotwo thousand threetwo thousand fourtwo thousand fivetwo thousand sixtwo thousand seventwo thousand eighttwo thousand ninetwo thousand tentwo thousand eleventwo thousand twelvetwo thousand thirteentwo thousand fourteentwo thousand fifteentwo thousand sixteentwo thousand seventeentwo thousand eighteentwo thousand nineteentwo thousand twentytwo thousand twenty-onetwo thousand twenty-twotwo thousand twenty-threetwo thousand twenty-fourtwo thousand twenty-fivetwo thousand twenty-sixName of homeschool Chief Administrator*The name listed with the North Carolina Division of Non-Public Education as you want it to appear on the diploma PaymentDiploma* Price: 6.75% Tax $0.00 7% Tax $0.00 7.25% Tax $0.00 7.5% Tax $0.00 Total Refund Policy* I agree to the refund policy, "cancelled orders will be issued a refund less incurred expenses." Billing Address* Billing address is same as above. Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name
