SAMFORD UNIVERSITY
CHANGE OF STUDENT PREFERRED NAME
Date Student I.D.:
Student Name
Last First Middle
Preferred Name:
*Students who complete this form in person must bring a photo ID. Students who choose to mail or fax the form must also provide a
photocopy of a picture ID (license, passport, etc.) along with the request. Changes will be made to preferred first names only, not surnames.
Student Signature (Required)