Change of Information

Full Student Name: *

Date of Birth: * +

Phone Number: *

Student ID #: *

Email: *

I affirm that I have read, understood, and agreed to this form in its entirety and that the information supplied is true and complete

Student Signature: *

clear

Were you able to sign using your mouse or finger in the signature field above? *

Yes

No

Typed Signature Field (for students using ADA screen-reading software): * 🛈

Student Signature Date: * +

***ONLY COMPLETE THE INFORMATION YOU NEED TO UPDATE***
Example: If you are updating your legal name, ONLY complete the name section.

Documentation is required when making changes to the information listed below, if the change has not been made on your Driver License or Passport.

Documentation includes one of the following:
• Legal name change/gender change document
• Marriage certificate
• Divorce decree, etc.
• Court Documents
Changes to your social security number (SSN) require a copy of your driver’s license as well as your social security card.
We do not accept unsigned social security cards.

Documentation is not required when changing preferred name or personal email address only. Photo ID is still required to confirm identity.

What would you like to update? (check all that apply): *

INFORMATION TO UPDATE:

Preferred First Name: 🛈

First Name:

Middle Name:

Last Name:

Would you like your email display name updated?

Yes

No

Personal Email Address:

Date Of Birth: +

SSN:

Citizenship:

Legal Sex:

Male

Female

A copy of your ID is required for all submission of electronic forms to the Office of the Registrar. Upload a copy of the front of your state ID or driver's license here along with any required documentation: *