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Return completed form to the Registrar’s Office
Plant Hall 90
(813) 253-6251 Fax: (813) 258-7238
registrar@ut.edu
Change of Gender
This form must be accompanied by a photocopy of an acceptable legal document reflecting the new gender.
Acceptable legal documents are a valid driver’s license or court order. Documents that are not considered
acceptable legal documents include documents from a medical or mental health professional, a social security
card, or notarized statement.
**using black ink is recommended**
Student’s Name (Last, First, M.I.)
Mr
Mrs
Miss
Ms
Dr
From male to female
From female to male
ID Number
Email Address
Phone Number
I certify that I am the above named person and the information I have provided is accurate.
Signature Date
Revised 3/2015
click to sign
signature
click to edit
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