Tennessee Tech | Office of the Registrar | Jere Whitson Building, Room 221 | 931.372.3317 | registrar@tntech.edu | tntech.edu/em/records/
Office of the Registrar
TENNESSEE TECH
Name of student: ____________________________________________ T#: _______________ Date: ___________
(Last) (First) (MI)
Name Change requests require: Social Security Card copy AND marriage certificate, divorce decree, or court order showing previous
name and new name. (If you are employed with the University, you must take your original SSN card to Human Resources for
verification).
Social Security Number corrections require: Social Security Card. (If you are employed with the University, you must take your
original SSN card to Human Resources for verification.)
Requests without appropriate documentation as stated above are considered incomplete and will not be processed.
Your Name as listed on your TTU record:
________________________________________________________________________________________________
(Last) (First) (Middle/Maiden) (Suffix) (Prefix)
New, Legal Name (as listed on your required documentation above):
________________________________________________________________________________________________
(Last) (First) (Middle/Maiden) (Suffix) (Prefix)
Social Security Number correction:
Name (as listed on your SSN card): ___________________________________________________________________
(Last) (First) (MI)
The SSN (as listed on your TTU record): ________________ The SSN (as listed on your card): ________________
Please check all that apply:
___ Employee (faculty, administrator, staff) ___ Current ___ Former
*Employee names must match the name as listed on your SSN card
___ Student ___ Current* ___ GA or Student Worker ___ F1/J1 Visa (Passport required)
___ Former __________ Last Term Attended
*Currently enrolled students must also notify instructors of name changes. To obtain a new Eagle Card with new name,
please request verification of name change through the Registrar’s Office, Jere Whitson 221.
I certify my name has legally changed as requested and that the supporting documents are true and exact copies of the
original. It is not my intent to defraud Tennessee Technological University.
Signature: __________________________________________ Date: _____________
