Request for Duplicate Credential Certificate

Instructions

Credential Certificates

Breining Institute provides a display-worthy Certificate to new credential holders, upon the initial issuance of each new credential, at no extra charge to the credential holder, which is sent to the credential holder by U.S. Postal Mail or equivalent service.

Upon each renewal of the credential, which is due every two years, Breining issues a handsome PDF electronic-version certificate by email to the renewed credential holder.

Replacement Certificate

Breining issues the “original” credential only upon initial issuance of the credential.

If an individual credential holder wishes a replacement of the original certificate, Breining will be pleased to provide such, upon receipt of the Request for Duplicate Credential Certificate form and $75 processing fee payment for each certificate ordered.

PLEASE NOTE: The replacement certificate will be produced in accord with the format currently used for Credentials issued by Breining Institute.

Prepare to provide documentation

Please be prepared to upload a copy of your original certificate, a copy of a government-issued ID card, and a recent photo of yourself.

Copy of Original Certificate(s) Upload

You will need to upload a copy or photo of each originally issued certificate that you wish to be provided.
The copy or photo of the certificate must be clearly legible, so that we can identify the name of the person to whom it was issued, the date of issuance, and the Credential number

Government-issued ID Card Upload

You will upload a copy of an identification card which includes your photo, such as a drivers license or passport or similar ID card that is issued by a government agency.
This ID card will be used for our internal identification verification purposes only.

Current Photograph Upload

You will upload a current photo of you.
The photo may be taken using your smart phone or similar device.
This photo will be used on our publicly-accessible website page that verifies the award of your credential(s).

If you are unable to upload the certificate, ID or photo within this form, you may send them to us by email at College@Breining.edu

Processing

Replacement Certificates are processed once per month, typically mid-month. Thus, it will typically take from 3 to 6 weeks before we have completed our archive search, created a new certificate, and submitted it to the U.S. Post Office (or other carrier) for delivery to you.

PLEASE NOTE: The Office of the Registrar takes responsibility for handling replacement certificate requests in a prompt and efficient manner. However, we are not responsible for mishandling by the U.S. Post Office or other shipping agencies.

Credential Holder Info

Credential Holder Information

Full Name: *

Other names (if applicable) under which the certificate(s) may have been issued:

Last four digits of your Social Security Number *

Date of Birth *

Email Address: *

Confirm Email Address: *

Primary Phone Number *

Documentation

If you are unable to upload the certificate(s), the ID or the photo, please send them to us by email at College@Breining.edu

Copy of Original Certificate(s) Upload

You will need to upload a copy or photo of each certificate that you wish to receive.
The copy or photo of the certificate must be clearly legible, so that we can identify the name of the person to whom it was issued, the date of issuance, and the Credential number

Certificate Upload

Government-issued ID Card Upload

Upload a copy of an identification card which includes your photo, such as a drivers license or passport or similar ID card that is issued by a government agency.
The copy of the ID should be in PDF or JPG format.
This ID card will be used for our internal identification verification purposes only.

Government-issued ID Card Upload

Current Photograph Upload

Upload a current photo of you.
Photo must be in color.
Facing forward, look straight to the camera.
No hats or sunglasses.
The photo may be taken using your smart phone or similar device.

This photo will be used on our publicly-accessible website page that verifies the award of your credential(s), and we will include it on your credential renewal certificate. In consideration of issuance of the credential referenced in this application, you expressly agree that the photo you submit and your likeness contained therein may be included in the Breining Institute “International Credential Verification (ICV) System” and posted on the credential verification pages of Breining Institute websites. By submitting the photo, you hereby release and discharge Breining Institute from any and all actions, claims and demands of any nature which you may have at any time now or in the future arising out of or related to the rights to the photo granted herein or your likeness.

Online Verification of Credentials

Current credential status may be verified online through the Breining Institute International Credential Verification System, Certified / Credentialed Counselors (CCCo), at this link: https://ccco.breining.edu/

Current Photograph Upload

If you are unable to upload the certificate(s), the ID or the photo, please send them to us by email at College@Breining.edu

Certificate Info

Replacement Certificate(s) Requested

Special Instructions (if any)

Please advise if there are special instructions, such as requesting more than one copy of a certain Credential.

Shipping of the duplicate Credential certificate to addresses within the United States is included, at no extra cost. There will be additional charges for shipping to addresses outside of the U.S., which will be charged to the credit card if you give us authorization to do so here.

Address and Payment Info

Address Information

Where do you want the certificate(s) sent?

We will send the requested certificate(s) to the mailing address you identify within this section. We will send them by regular First Class mail, using the U.S. Postal Service (USPS). If you desire expedited service, you may select the USPS Priority Mail option when completing the Payment Information, below.

Name *

Street address (include Apt or Suite number, if applicable) *

City: *

State / Province: *

ZIP Code or Country Code:

Country:

Country (if not the United States):

Payment Information

Order *

Select the number of certificate(s) you are ordering:

$75: I am ordering ONE (1) certificate to be sent via regular First Class USPS mail to the person and address identified above.

I am ordering more than one certificate to be sent via regular First Class USPS mail to the person and address identified above. I authorize a charge to my credit card of $75 for each certificate ordered.

Optional expedited shipping:

$40: Add this charge to send my certificate(s) via USPS Priority Mail to the person and address identified above.

You give permission to and authorize Breining Institute is authorized to charge the total amount of the item(s) selected, above, to the following credit card:

Credit Card: *

VISA

MasterCard

Discover

Credit Card Number: *

Credit Card Expiration Date *

Full Name on Credit Card: *

Are you ready to submit your request?

PLEASE NOTE: Duplicate Certificates are processed once per month, typically mid-month. Thus, it will typically take from 3 to 6 weeks before we have completed our archive search, created a new certificate, and submitted it to the U.S. Post Office (or other carrier) for delivery to you.

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