CHANGE of Student Record Information
Provide your name and SCCID# as they currently appear on your SCC student records
Last First MI SCC ID
Telephone # ___________________ Date of Birth: _______
1.
2.
3.
Address - Change to:
Street City/State/Zip Code
4.
Email Address – Change to:
5.
Telephone Number –
Change to:
(
)
6.
Date of Birth – Change to:
/ /
7.
( ) Verified I.D.
__________ Initials
__________ Date
K12 to Grad or
Grad to K12
For Office Use Only:
Student Signature Date
By:
____ Date: _________
A&R_12.03.2019 MA
-
8.
Please check √ each item you wish to change & print/type those changes in the spaces provided:
Legal Name* - Change to: Last First MI
Preferred First Name** -
Social Security Number*** - Change to:
*An updated copy of a government issued ID or court approved paperwork must accompany a legal name change
request.
**Due to legally mandated record keeping requirements and potential system issues, your preferred first name may
not show in all places across Solano College systems. Please be aware that preferred first name will not show on
transcripts, grade reports, diplomas and on some class rosters that may be used by faculty.
***A SSN change requires that you include a copy of your SSN card for verification.
(staff enter into SPAIDEN preferred name field only)
click to sign
signature
click to edit
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