Duplicate Registration Certificate

Cost: $10 (+$3 for PayPal)
Assistant Information
Your duplicate registration certificate will be mailed to the address on file.
Mailing Address*
The board has my most up-to-date mailing address that has a mail receptacle. I understand that it will be mailed to the address on file.
- Yes, I understand
Name*
Prefix First Middle Last
Registration Number*
Email (for PDF delivery)*
Please enter an email address to receive a copy of this completed form. This is not a copy of your registration certificate. The registration certificate will be mailed to the address on file.
Payment Information
Duplicate Registration Certificate fee
Convenience Fee
Total
$0.00
Payment Method*

American Express
Discover
MasterCard
Visa
Maestro
Supported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro
Card Number Expiration Date Security Code Cardholder Name

Save and Continue Later

Assistant Information