505 Ramapo Valley Road, Mahwah, NJ 07430-1680
Phone (201) 684-7695 Fax (201) 684-7956
Use Only: Staff Initials:______________ Date:________________
_____ Updated in SIS ____ Updated Student file ____ Contacted IT ____ Emailed
Update 4/30/20 P:\Shared\Registrar\Forms\Name Change Forms\Student Change of Name forms 4.30.20.docxOffice
New Jersey’s Public Liberal Arts College
Request for Change of Name on Student Records
1. A. If this form is being used to correct spelling of format, it must be accompanied by a copy of a positive form
of ID. Acceptable documents are driver’s license, birth certificate or a passport.
B. If this is being used to change to a different name (first or last), it must be accompanied by a copy of the legal
document authorizing the change. Acceptable documents are: Marriage Certificate, Divorce Decree or Court issued
Judgment for Name Change.
C. If this is being used to add a middle name or Suffix it must be accompanied by a copy of your birth certificate.
2. Student R # _________ _____ or if prior to Fall 2006, ID# ______ .
3. Former Name:
Last Name First Name Middle
Requested Name:
Last Name First Name Middle
4. Status:
Currently Enrolled Former Student (non graduate) Graduate of Ramapo College
5: Ramapo E-Mail Account:
Currently enrolled students may request a change to their email username.
Please initial here if you are requesting a new username_________.
6. Statement by Student:
I affirm that the request for a change of name in the Office of the Registrar’s records has no fraudulent or criminal
purpose and that I am presently known by this name and no other.
I understand that if a replacement diploma is not ordered, the college is not responsible for any confusion that may
arise in verifying a degree.
Signature Date
Please mail or fax this form and the required documents to:
Ramapo College of New Jersey, Office of the Registrar, 505 Ramapo Valley Road, Mahwah, NJ 07430
Fax (201) 684-7956
click to sign
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome