Personal DetailsThis field is hidden when viewing the formSchool NamePlease note that all information shared herein will remain strictly confidential. Any fields marked with * are required. First Name*Middle NameLast Name*Height*Please select an option<4'5"4'6"4'7"4'8"4'9"4'10"4'11"5'0"5'1"5'2"5'3"5'4"5'5"5'6"5'7"5'8"5'9"5'10"5'11"6'0"6'1"6'2"6'3"6'4"6'5"6'6"6'7"6'8"6'9"6'10">6'10"Your Height*Weight (lbs)*Please select an option<160160-170170-180180-190190-200200-210210-220220-230230-250250-270270-300300-330330-360360-400>400Academic InformationStudent ID#*Your Hometown***Hometown to be printed in commencement program City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Are you a Belhaven Legacy?*You have a family member that previously attended Belhaven University Yes No Please list the relative(s) who have attended Belhaven University and their relationship to you.*Please click the plus symbol to add additional family membersFamily Member's NameRelationship to Self Do you have a family member who works at Belhaven University?* Yes No Please list the relative(s) that work at Belhaven University and the department they work in.*Please click the plus symbol to add additional family membersFamily Member's NameDepartment Degree I will be receiving*Please select an optionAssociateBachelorMasterSpecialistDoctorDiscipline*Please select an optionMABTS in Biblical and Theological Studies (Red)MAT in Education (Light Blue)MBA in Business Administration (Drab)MED in Education (Light Blue)MED in School Leadership & Supervision (Light Blue)MEDRL in Education (Light Blue)MFA in Fine Arts (Brown)MHA in Health Administration (Sage)MML in Christian Ministry Leadership (Drab)MOL in Organizational Leadership (Drab)MPA in Public Administration (Peacock)MSA in Sports Administration (Sage)MSITM in Information Technology Management (Drab)MSL in Leadership (Drab)Discipline*Please select an optionDBA (Drab)EdD (Light Blue)Regalia NeededAssociate Regalia Package*Includes cap, gown, tassel, and any applicable taxes. Price: Bachelor Regalia Package*Includes cap, gown, tassel, and any applicable taxes. Price: Master Regalia Package*Includes cap, gown, hood, tassel, and any applicable taxes. Please be advised that the hood velvet you receive will be representative of your discipline - Light Blue is shown for reference. Price: Specialist Regalia Package*Includes cap, gown, hood, tassel, and any applicable taxes. Price: EdD Regalia Package*Includes tam, gown, hood, tassel, and any applicable taxes. Price: DBA Regalia Package*Includes tam, gown, hood, tassel, and any applicable taxes. Price: Complete Your SubmissionRegalia Distribution Options*You have the choice of picking up your regalia at the Belhaven University Bookstore during the designated dates or having it shipped to your home. - If you choose IN-STORE PICK-UP: Your regalia will be able to be picked-up at the Belhaven University Bookstore starting Wednesday, April 23, 2025. - If you choose SHIP-TO-HOME: Your regalia order will be shipped during the week of April 16, 2025. IN-STORE PICK-UP at the Belhaven University Bookstore: NO ADDITIONAL FEE SHIP-TO-HOME : ADDITIONAL $20.00 FEE Shipping Fee* Email Address*Your receipt will be sent to the email address provided. If you do not receive a receipt via email, please check your spam/junk folder, then email service@gradsupply.com. Enter Email Confirm Email Billing Address*IMPORTANT - Please be sure to enter the billing information that is on file with your credit/debit card provider. 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NOTICE: PO Boxes will not be accepted - Physical mailing address required Same as Billing Street Address City 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 State ZIP Code Credit Card* Cardholder Name Card Details I understand that I must visit www.gradsupply.com/student-orders by April 2, 2025, to request a refund if I wish to cancel my order. I also understand that after the April 2, 2025, refund request deadline my regalia order becomes non-refundable.* I agree I have reviewed my responses and payment details above to verify accuracy.*Please enter your (the graduate's) first and last names to verify Total $0.00 Once you click Submit, you will not be able to change or cancel your order. NameThis field is for validation purposes and should be left unchanged. CONTACT US © 2025 All Rights Reserved · Graduate Supply House, Inc.