Rev. 1/15
Change of Information Form
Student ID: _______________________
Current Name on File: _____________________________________________________________
Complete all sections that apply:
Change Address To:
Street____________________________________________ Bldg./Apt. #________________
City___________________________ State________ Zip Code__________________
County________________________*Any change to Morris County residency (for tuition purposes) must be
approved by the Office of the Vice President for Student Development & Enrollment Mgmt. (SCC 132)
Home Phone # _________________________ Cell Phone #____________________________
Change Personal Email Address To:
________________________________________________________________________________
Change Name To:
_______________________ _______________________ ________________________________
First Name Middle Name Last Name
*Official documentation supporting your name change is required. (i.e.: Social Security Card, License, Court decree, etc.)
Change Social Security Number To:
___ ___ ___ - ___ ___ - ___ ___ ___ ___ ___ ___ ___ - ___ ___ - ___ ___ ___ ___
New Social Security Number Old Social Security Number
*Please provide new Social Security Card
Student Signature________________________________________ Date_______________________
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Records & Registration Use Only:
Processed by: __________ Date: ___________________
DMRS Processed_________ STU email deleted_________
