Southeastern Louisiana University
NAME CHANGE FORM
To change your name, please print and complete the following form. After completing all fields, sign and date it, then
mail or fax the form with the required documentation to the Office of Records and Registration. If you are currently
enrolled, your new name will not be changed on university records until the end of the current school session.
Therefore, please continue to use the name under which you registered throughout this current school session.
Southeastern Louisiana University
Office of Records and Registration
SLU 10752
Hammond, LA 70402
Fax: (985) 549-5632
Please print or type your name as it currently appears on University records:
Last Name: First Name: Middle/Other:
Student ID: Date of Birth: Phone Number:
I request that the name on my records be changed to the following:
Last Name: First Name: Middle /Other:
Copies of the following items must accompany this form:
AND
Reason for name change ---Copy of legal document(s) must accompany this form:
Social Security Card (Name on Social Security Card must match your requested new name and the card must be signed).
Other:
Divorce (copy of divorce decree required)
Court Order (copy of court order required)
Marriage (copy of marriage license required)
(copy of legal documentation required)
Please Note: *If your name is the result of a divorce and a marriage, copies of both the divorce decree
and marriage license will be required.
*If you are an international student on F-1 visa, you are required to notify the International
Student Affairs Officer of any name change.
Please make the requested change to my records.
Signature: Date:
(signature is required)
Please check if you applied for graduation. This request will not change your diploma name that you
indicated on your Application for Graduation.
