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TexasWoman’sUniversity

OfficeoftheRegistrar

TWUOfficeoftheRegistrarPOBox425559Denton,TX76204E‐mail:registrar@twu.eduFax:940‐898‐3097Phone:940‐898‐3036

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DocType:_____NAE______

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Description:_____/_______

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Forofficeuseonl

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StudentInformationChanges

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StudentID:_____________________________ DateofBirth:___________/________/_____________

LastName

____________________________FirstName__________________________Middle_________

CurrentlyEnrolled____Y____N__ Ifnot,dateoflastenrollment:___________________________________

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TWUe‐mail:_________________________________Alte‐mail:________________________________________

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ONLYCOMPLETETHESECTION(S)PERTAININGTOINFORMATIONYOUAREUPDATING

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________________________________________________________________

StudentSignatureDate

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_____NameChangeorPersonalInformation

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FormerName:__________________________________________________________________________________________

LastFirstMiddleInitial

NewName:____________________________________________________________________________________________



LastFirstMiddleInitial

NameChangeReason:___________________________________________________________________________________

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*INCLUDEACOPYOFCORRECTSIGNEDSOCIALSECURITYCARDorCOURTISSUED

FINAL ORDER OF NAME CHANGE

AND A COPY OF GOVERNMENT ISSUED PHOTO

_____PersonalInformationChange

Phonenumber:________________________________Altnumber:_____________________________________

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Mailingaddress:________________________________________________________________________________

StreetCityState Zip

Permanentaddress:______________ _______________________________________________________________

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DateofBirthCorrection:_______/______/_________GenderChangeFrom:___________To:_______________

Driver’sLicenseCorrection:State:___________LicenseNumber:________________________________________

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*INCLUDEACOPYOFGOVERNMENTISSUEDPHOTOID*

_____EmergencyContactChange

EmergencyContactName:___________________________________Relationship:_________________________

EmergencyContactPhone:________________________________AltPhone:______________________________

EmergencyContactAddr ess:______________________________________________________________________

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StreetCityStateZip

ContactforMissingPerson:___Y___N 

*Additionalcontactsmaybeaddedbysubmittingadditionalforms.

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*INCLUDEACOPYOFACOPYOFGOVERNMENTISSUEDPHOTOID*

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