Fill - Free fillable Namechangerequest (Trinity Bible College & Graduate School) PDF form

OfficeoftheRegistrar

506

AvenueSouth

Ellendale,ND58436

Ph:(701)349‐5796

Fax:(701)349‐5786

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NameChangeRequest

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Instructions:

A. spelling,itmustbeaccompaniedbyacopyofapositiveformof

ID.Acceptabledocumentsareadriver’slicense,birthcertificate,orapassport.

B. Ifthisformisbeingusedt

Ifthisformisbeingusedtocorrect

ochangetoadifferentname(first,middle,orlast),itmustbe

accompaniedbyacopyofthelegaldocumentauthorizingthechange.Acceptabledocumentsare:

MarriageCertificate,DivorceDecree,oracourtissuedJudgmentforNameChange.



StudentInformation:



StudentIDorSocialSecur



ityNumber:__________________ _ DateofBirth: 

CurrentNameonRecord:

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Last 



First  Middle  Suffix 

estedName:Requ 

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Last  First  Middle  Suffix 

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Statu 

  CurrentlyEnrolled

 FormerStudent(nongraduate)

 GraduateofTrinityBibleCollege

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ContactInformation:

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Address:  

City:

 State:  ZipCode:

Email:  

Phone#



(bestcontact):

HomeCellWork

PleaseReadBeforeYouSign:IaffirmthattherequestforachangeofnameintheRegistrar’srecordshasno

fraudulentorcriminalpurposeandthatIampresentlyknownbythisnameandnoother.Further,Icertifythatitis

myintenttousethisnameconsistentlyforthesepurposesatTrinityBibleCollege.

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Signature: 

 Date: 

 



taffName:

ForOfficeUseOnly:

S  StaffTitle:  DateProcessed:

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