Personal Information Update Form
Student Information
Student I.D. Full Name: DOB:
First Name Middle Name Last Name
Information to be Updated
I am requesting the following information to be changed/updated:
Email/Phone Address Name Date of Birth Social Security Number
Update Contact Information
Email: Phone:
Update Address
This is my mailing Address: This is my physical address:
Street Address: Apt #: Street Address: Apt #:
City: State: Zip: City: State: Zip:
This is both my physical AND mailing address
Moving from out of District to In-District (see below for required documentation.)
PROOF IS RQUIRED IF YOU ARE MOVING FROM OUT-OF-DISTRICT TO IN-DISTRICT. YOU MUST PROVIDE ONE
OF THE FOLLOWING TYPES OF PROOF LISTED BELOW:
• Texas Driver’s License with new address
• Copy of current lease with name and new address
This form will not establish Texas Residency.
Students that need to prove Texas Residency will be required to complete additional documentation.
Update Information
Please fill out only the portion of personal information you wish to update
Name of Record
Name on Record:
Updated Name:
Date of Birth Social Security Number
DOB on Record: SSN on Record:
Updated DOB: Updated SSN:
Please note the following required documentations:
• Social Security Number Change: Social Security Card is required if you are changing your name or Social Security Number
• Date of Birth Change: Birth Certificate is required if you are changing your Date of Birth
Signature
I certify that the information on this form is complete and correct and understand that submission of false information is
ground for cancellation of enrollment or appropriate disciplinary action.
Student Signature: Date:
Office of the Registrar 101 Baldwin Blvd Corpus Christi, TX 78418 reginfo@delmar.edu
361-698-1248 Fax: 361-698-1857
For office Use Only Posted by: __________ Date Posted: __________
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signature
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