CHANGE OF NAME
Name (Last, First, MI)
*
Date of Birth
*
/
Month
/
Day
Year
Date
Student ID
*
Phone
*
Format: (000) 000-0000.
Email
*
example@example.com
Reason for Name Change
*
Adoption
Divorce
Marriage
Preference
Previous Name
Yo
u must provide official documentation: copy of marriage license, divorce decree or court document only.
A copy of a driver’s license is not a valid form of identification for a name change.
Upload official copies of documentation
*
Browse Files
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Choose a file
Cancel
of
New
Name:
*
Write name EXACTLY as you want it to
appear on your academic record*
First
*
Middle
*
Last
*
Student’s Signature
*
Date
*
/
Month
/
Day
Year
Date
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