Office of the Registrar
601 W. Lombard Street, Suite 240
Baltimore, MD 21201
410-706-7480 | 410-706-4053 fax
registrar@umaryland.edu
Request for Citizenship Status Change
Instructions: This form is used for students to request for a change to their citizenship status on their
student records. The student must complete this form and present the original supporting
documentation to the Office of the Registrar. The original documents will be returned to the student
after a copy is made. Once the records are updated, the student will be notified by email.
STUDENT INFORMATION (Please print):
Student ID Number (@XXXXXXXX):_____________________
Date of Birth (mm/dd/yyyy): _________________________
Name: ____________________________ _________________________ __________________
Last First Middle
Citizenship Status Change to:
U.S. Citizen
Permanent Resident
Asylee/Refugee
Student Signature: ______________________________________ Date: _____________________
FOR OFFICE USE ONLY:
PROCESSED BY: __________________ DATE: _______________
ORR 9/2018
