Personal Data Change Request
Enrollment Center College Center building, upper level (651) 450-3503
Indicate the reason you are submitting this form (check all that apply).
Legal change of name
Correction of existing name (data entry error in system)
Legal change of existing SSN or National ID
Correction of existing SSN or national ID (data entry error in system)
Update marital status
Driver’s license or state identification
Marriage Certificate
Social security card with signature
(this must accompany a social security number change)
Divorce decree
Valid/unexpired passport
(required for F-1 and J-1 international student requests)
Court order
I Authorize Inver Hills Community College to update my personal information per this request, and to correspond with
me, if necessary, at the above personal contact information. I verity that all documentation and identification presented is
current and accurate.
Student’s Signature
Please note: your mailing address and email address can be updated in E-Services under Account Management.
Former Last Name (Currently on Record):
Former First Name (Currently on Record):
Former Middle Name (Currently on Record):
New Last Name:
New First Name:
New Middle Name:
Inver Hills Student ID Number:
Former Social Security Number
Or National ID (Currently on Record):
New Social Security Number
Or National ID (If Applicable):
Current Address:
Current Phone Number:
E-mail Address:
Submit TWO forms of Identification
from this column. At least one must be a
photo ID
Submit ONE form of documentation
from this column.