Caldwell Community College
and Technical Institute
Permanent Record Change Form
2855 Hickory Blvd., Hudson, NC 28638
Post Office Box 3318, Boone, NC 28607
Please submit this form and documentation to Student Services on the Caldwell or Watauga Campus.
My record information is currently listed as:
Social Security Number
Please make the following changes to my permanent record information.
Reason: Marriage Court Action Other
Copy of legal document authorizing the name change must be attached to process change.
Name changes do not affect your user ID for Mycccti and Webadvisor.
Change my social security number to:
Copy of social security card must be attached to process change.
Change my primary phone number to:
Change my secondary phone number to:
Proof of birth date must be provided.
I hereby authorize Caldwell Community College and Technical Institute to change my permanent record information as indicated above.
click to sign
click to edit