Change of Name Form
I was formerly known as: ______________________________________________
I am now known as: __________________________________________________
Signature: __________________________________________________________
Student ID (if known): ________________________________________________
Supporting Documents (marriage license, court documents etc.) must be
attached to substantiate this change.
Return this form and documents to the Office of the Registrar.
Office of the Registrar
1000 State Street
Springfield, MA 01109
Fax (413)205-3974
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