LEGAL NAME CHANGE FORM
Please Print Legally
FORMER Name: ______________________________________________________________________
First Middle Last
NEW Name: _________________________________________________________________________
First Middle Last
Student Number or Last four of SSN: ______________________
Academic College: ______________________________
Major: _______________________________________
Signature: _____________________________________ Date: __________________________
NOTE: Please allow one working day from receipt of this form for the name to be changed in the Student
Information System. In order to verify your name change, we are required to see government-issued
documentation which shows your name as you wish it to appear on your official record.
REGISTRARS OFFICE USE ONLY
Processed By: ___________________________ Date: ______________________