Fillable Office of the Registrar 379 Belmont Road, Laconia, (Lakes Region Community College)

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Office of the Registrar 379 Belmont Road, Laconia, (Lakes Region Community College)

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The Office of the Registrar 379 Belmont Road, Laconia, (Lakes Region Community College) form is 1 page long and contains:

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  • 22 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Lakes Region Community College

BROWSE LAKES REGION COMMUNITY COLLEGE FORMS

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Student Name: __________________________________________ Student ID: __________________________
DOB: _______________________
CHANGE (Check all that apply) ☐Name* ☐Address ☐Phone ☐Email
*Request for name changes must be accompanied by supporting documentation; (i.e., Driver’s License, Marriage or
Divorce Certificate, Social Security Card, Birth Certificate).
Information as it appears on
PRESENT LRCC records.
CHANGE TO:
(fill in appropriate information)
Last Name
Last Name
First Name
First Name
Mailing Address
Mailing Address
City
City
State Zip Code
State Zip Code
Home Phone
Home Phone
Cell Phone
Cell Phone
Business Phone
Business Phone
Email
Email
Student Signature ___________________________________________ Date ____________________
Change of Personal Information Request
Office of the Registrar
379 Belmont Road, Laconia, NH 03246
Phone: (603) 524-3207 Fax: (603) 524-8084
Email: lrccregistrar@ccsnh.edu
Rev 5/22/2018
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Office of the Registrar 379 Belmont Road, Laconia, (Lakes Region Community College)

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Completed 26 July 2020

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